Skip to main content
PMC home page
Clinical and Diagnostic Laboratory Immunology logoLink to Clinical and Diagnostic Laboratory Immunology
. 1995 Jul;2(4):454–457. doi: 10.1128/cdli.2.4.454-457.1995

Measurement of sputum antibodies in the diagnosis of acute and chronic respiratory infections associated with Chlamydia pneumoniae.

L von Hertzen 1, M Leinonen 1, H M Surcel 1, J Karjalainen 1, P Saikku 1
PMCID: PMC170178  PMID: 7583923

Abstract

The aim of this study was to develop methods for the measurement of sputum antibodies in the laboratory diagnosis of acute and chronic lower respiratory tract infections caused by Chlamydia pneumoniae. Paired serum specimens, sputum specimens, and pharyngeal or nasopharyngeal swabs were obtained from 97 patients; 51 of them had community-acquired pneumonia, and 46 had chronic obstructive pulmonary disease (COPD). C. pneumoniae-specific serum immunoglobulin G (IgG), IgA, and IgM antibodies were measured by the microimmunofluorescence (micro-IF) test. For sputa, specific IgA and IgG antibodies were measured by the micro-IF test and secretory IgA (sIgA) was measured by enzyme immune assay (EIA) with C. pneumoniae elementary bodies as the antigen. Sputum IgA and sIgA antibodies to C. pneumoniae were found, respectively, in 52 and 51% of the COPD patients. Elevated levels of stable serum IgG and IgA antibodies (IgG titer of > or = 128 and IgA titer of > or = 40), suggesting chronic infection, were found in 54% of the COPD patients. The sensitivity for the sputum IgA micro-IF test compared with elevated serum antibody levels was 87.5%, and that for the sputum sIgA EIA was 88%; the respective specificities were 90 and 95%. Acute C. pneumoniae infection was diagnosed in seven pneumonia patients, and two (29%) of these patients were positive by sputum EIA antibody measurements. Two pneumonia patients without acute infection had stable elevated IgG and IgA levels in their sera, and both of them were sputum antibody positive. We conclude that the measurement of IgA antibodies to C. pneumonia in sputum is a useful additional diagnostic tool for chronic C. pneumoniae infections.

Full Text

The Full Text of this article is available as a PDF (190.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allardyce R. A., Bienenstock J. The mucosal immune system in health and disease, with an emphasis on parasitic infection. Bull World Health Organ. 1984;62(1):7–25. [PMC free article] [PubMed] [Google Scholar]
  2. Blasi F., Legnani D., Lombardo V. M., Negretto G. G., Magliano E., Pozzoli R., Chiodo F., Fasoli A., Allegra L. Chlamydia pneumoniae infection in acute exacerbations of COPD. Eur Respir J. 1993 Jan;6(1):19–22. [PubMed] [Google Scholar]
  3. Burnett D., Hill S. L., Bradwell A. R., Stockley R. A. IgA subclasses in sputum from patients with bronchiectasis. Respir Med. 1990 Mar;84(2):123–127. doi: 10.1016/s0954-6111(08)80014-5. [DOI] [PubMed] [Google Scholar]
  4. Darougar S. The humoral immune response to chlamydial infection in humans. Rev Infect Dis. 1985 Nov-Dec;7(6):726–730. doi: 10.1093/clinids/7.6.726. [DOI] [PubMed] [Google Scholar]
  5. Ekman M. R., Leinonen M., Syrjälä H., Linnanmäki E., Kujala P., Saikku P. Evaluation of serological methods in the diagnosis of Chlamydia pneumoniae pneumonia during an epidemic in Finland. Eur J Clin Microbiol Infect Dis. 1993 Oct;12(10):756–760. doi: 10.1007/BF02098463. [DOI] [PubMed] [Google Scholar]
  6. Gaydos C. A., Eiden J. J., Oldach D., Mundy L. M., Auwaerter P., Warner M. L., Vance E., Burton A. A., Quinn T. C. Diagnosis of Chlamydia pneumoniae infection in patients with community-acquired pneumonia by polymerase chain reaction enzyme immunoassay. Clin Infect Dis. 1994 Jul;19(1):157–160. doi: 10.1093/clinids/19.1.157. [DOI] [PubMed] [Google Scholar]
  7. Grayston J. T., Campbell L. A., Kuo C. C., Mordhorst C. H., Saikku P., Thom D. H., Wang S. P. A new respiratory tract pathogen: Chlamydia pneumoniae strain TWAR. J Infect Dis. 1990 Apr;161(4):618–625. doi: 10.1093/infdis/161.4.618. [DOI] [PubMed] [Google Scholar]
  8. Grayston J. T. Infections caused by Chlamydia pneumoniae strain TWAR. Clin Infect Dis. 1992 Nov;15(5):757–761. doi: 10.1093/clind/15.5.757. [DOI] [PubMed] [Google Scholar]
  9. Hahn D. L., Dodge R. W., Golubjatnikov R. Association of Chlamydia pneumoniae (strain TWAR) infection with wheezing, asthmatic bronchitis, and adult-onset asthma. JAMA. 1991 Jul 10;266(2):225–230. [PubMed] [Google Scholar]
  10. Herrmann B., Stenberg K., Mårdh P. A. Immune response in chlamydial conjunctivitis among neonates and adults with special reference to tear IgA. APMIS. 1991 Jan;99(1):69–74. doi: 10.1111/j.1699-0463.1991.tb05120.x. [DOI] [PubMed] [Google Scholar]
  11. Kleemola M., Saikku P., Visakorpi R., Wang S. P., Grayston J. T. Epidemics of pneumonia caused by TWAR, a new Chlamydia organism, in military trainees in Finland. J Infect Dis. 1988 Feb;157(2):230–236. doi: 10.1093/infdis/157.2.230. [DOI] [PubMed] [Google Scholar]
  12. Kuo C. C., Grayston J. T. A sensitive cell line, HL cells, for isolation and propagation of Chlamydia pneumoniae strain TWAR. J Infect Dis. 1990 Sep;162(3):755–758. doi: 10.1093/infdis/162.3.755. [DOI] [PubMed] [Google Scholar]
  13. Maass M., Essig A., Marre R., Henkel W. Growth in serum-free medium improves isolation of Chlamydia pneumoniae. J Clin Microbiol. 1993 Nov;31(11):3050–3052. doi: 10.1128/jcm.31.11.3050-3052.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Marrie T. J., Grayston J. T., Wang S. P., Kuo C. C. Pneumonia associated with the TWAR strain of Chlamydia. Ann Intern Med. 1987 Apr;106(4):507–511. doi: 10.7326/0003-4819-106-4-507. [DOI] [PubMed] [Google Scholar]
  15. McComb D. E., Nichols R. L., Semine D. Z., Evrard J. R., Alpert S., Crockett V. A., Rosner B., Zinner S. H., McCormack W. M. Chlamydia trachomatis in women: antibody in cervical secretions as a possible indicator of genital infection. J Infect Dis. 1979 Jun;139(6):628–633. doi: 10.1093/infdis/139.6.628. [DOI] [PubMed] [Google Scholar]
  16. McGhee J. R., Mestecky J. In defense of mucosal surfaces. Development of novel vaccines for IgA responses protective at the portals of entry of microbial pathogens. Infect Dis Clin North Am. 1990 Jun;4(2):315–341. [PubMed] [Google Scholar]
  17. Mestecky J., McGhee J. R. Immunoglobulin A (IgA): molecular and cellular interactions involved in IgA biosynthesis and immune response. Adv Immunol. 1987;40:153–245. doi: 10.1016/s0065-2776(08)60240-0. [DOI] [PubMed] [Google Scholar]
  18. Rook G. A., Hernandez-Pando R., Lightman S. L. Hormones, peripherally activated prohormones and regulation of the Th1/Th2 balance. Immunol Today. 1994 Jul;15(7):301–303. doi: 10.1016/0167-5699(94)90075-2. [DOI] [PubMed] [Google Scholar]
  19. Saikku P., Leinonen M., Mattila K., Ekman M. R., Nieminen M. S., Mäkelä P. H., Huttunen J. K., Valtonen V. Serological evidence of an association of a novel Chlamydia, TWAR, with chronic coronary heart disease and acute myocardial infarction. Lancet. 1988 Oct 29;2(8618):983–986. doi: 10.1016/s0140-6736(88)90741-6. [DOI] [PubMed] [Google Scholar]
  20. Saikku P., Leinonen M., Tenkanen L., Linnanmäki E., Ekman M. R., Manninen V., Mänttäri M., Frick M. H., Huttunen J. K. Chronic Chlamydia pneumoniae infection as a risk factor for coronary heart disease in the Helsinki Heart Study. Ann Intern Med. 1992 Feb 15;116(4):273–278. doi: 10.7326/0003-4819-116-4-273. [DOI] [PubMed] [Google Scholar]
  21. Terho P., Meurman O. Chlamydial serum IgG, IgA and local IgA antibodies in patients with genital-tract infections measured by solid-phase radioimmunoassay. J Med Microbiol. 1981 Feb;14(1):77–87. doi: 10.1099/00222615-14-1-77. [DOI] [PubMed] [Google Scholar]
  22. Underdown B. J., Schiff J. M. Immunoglobulin A: strategic defense initiative at the mucosal surface. Annu Rev Immunol. 1986;4:389–417. doi: 10.1146/annurev.iy.04.040186.002133. [DOI] [PubMed] [Google Scholar]
  23. Wang S. P., Grayston J. T. Immunologic relationship between genital TRIC, lymphogranuloma venereum, and related organisms in a new microtiter indirect immunofluorescence test. Am J Ophthalmol. 1970 Sep;70(3):367–374. doi: 10.1016/0002-9394(70)90096-6. [DOI] [PubMed] [Google Scholar]

Articles from Clinical and Diagnostic Laboratory Immunology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES