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1999 Selected Abstracts from American Urological Association annual meeting

Chlamydia Pneumoniae in Patients With Interstitial Cystitis

JJ Franke; CW Stratton and WM Mitchell; Nashville, TN (Presented by Dr. Franke)
Introduction and Objectives:
Since the identification of Chlamydia pneumoniae there has been evidence to indicate that it is an important human pathogen. Clearly it is associated with respiratory tract infections, but the scope of more disseminated C. pneumoniae infections is yet to be defined. This organism, which is transmitted by fomities, is fairly ubiquitous. Seroepidemiological data indicates that the incidence of previous exposure to C. pneumoniae increases with age. C. pneumoniae has been identified in endothelial cells, macrophages, and smooth muscle cells of atheromatous plaques, and an association with coronary artery disease is being investigated. In all C. pneumoniae infections, it is the secondary inflammatory response which is felt to impact most upon the end organ. Disseminated C. pneumoniae may play a role in the pathogenesis of chronic inflammatory diseases like interstitial cystitis (IC). Our objective is to determine if there is an increased incidence of urinary C. pneumoniae infection in IC patients.
As an obligate intracellular organism, C. pneumoniae can be detected with the use of tissue culture or polymerase chain reaction (PCR) to detect organism-specific DNA such as the major outer membrane protein (MOMP) gene. 32 IC patients and 12 normal volunteers were analyzed by serum and urine PCR to MOMP. 11 IC patients underwent bladder biopsy tissue culture.
Serum PCR positivity was 94% for IC patients and 83% for controls. This difference is not statistically significant, which correlates with the increasing sero-positivity with age in the normal population. Urine PCR positivity was 81% for IC patients and 27% for controls, which is significant with a p0.05. In addition, all eleven bladder biopsies obtained from IC patients were tissue culture positive for C. pneumoniae.
There is a statistically significant increase in urine PCR to C. pneumoniae MOMP gene in patients with IC. Further age-matched control data is being obtained to clarify its role in the pathogenesis of IC. In addition, urine PCR to the MOMP gene may be an important marker for the disease.
Source: 1999 AUA Meeting
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