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''Chlamydia pneumoniae'' is a species of ''
Chlamydia Chlamydia, or more specifically a chlamydia infection, is a sexually transmitted infection caused by the bacterium '' Chlamydia trachomatis''. Most people who are infected have no symptoms. When symptoms do appear they may occur only several we ...
'', an obligate intracellular bacterium that infects humans and is a major cause of
pneumonia Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severit ...
. It was known as the Taiwan acute respiratory agent (TWAR) from the names of the two original isolates – Taiwan (TW-183) and an acute respiratory isolate designated AR-39. Briefly, it was known as ''Chlamydophila pneumoniae,'' and that name is used as an alternate in some sources. In some cases, to avoid confusion, both names are given. ''Chlamydia pneumoniae'' has a complex life cycle and must infect another cell to reproduce; thus, it is classified as an
obligate intracellular pathogen {{wiktionary, obligate As an adjective, obligate means "by necessity" (antonym ''facultative'') and is used mainly in biology in phrases such as: * Obligate aerobe, an organism that cannot survive without oxygen * Obligate anaerobe, an organism that ...
. The full
genome In the fields of molecular biology and genetics, a genome is all the genetic information of an organism. It consists of nucleotide sequences of DNA (or RNA in RNA viruses). The nuclear genome includes protein-coding genes and non-coding ...
sequence for ''C. pneumoniae'' was published in 1999. It also infects and causes disease in
koala The koala or, inaccurately, koala bear (''Phascolarctos cinereus''), is an arboreal herbivorous marsupial native to Australia. It is the only extant representative of the family Phascolarctidae and its closest living relatives are the ...
s, emerald tree boas (''Corallus caninus''), iguanas,
chameleon Chameleons or chamaeleons (family Chamaeleonidae) are a distinctive and highly specialized clade of Old World lizards with 202 species described as of June 2015. The members of this family are best known for their distinct range of colors, bein ...
s, frogs, and turtles. The first known case of infection with ''C. pneumoniae'' was a case of conjunctivitis in
Taiwan Taiwan, officially the Republic of China (ROC), is a country in East Asia, at the junction of the East and South China Seas in the northwestern Pacific Ocean, with the People's Republic of China (PRC) to the northwest, Japan to the no ...
in 1950. There are no known cases of ''C. pneumoniae'' in human history before 1950. This atypical bacterium commonly causes
pharyngitis Pharyngitis is inflammation of the back of the throat, known as the pharynx. It typically results in a sore throat and fever. Other symptoms may include a runny nose, cough, headache, difficulty swallowing, swollen lymph nodes, and a hoa ...
,
bronchitis Bronchitis is inflammation of the bronchi (large and medium-sized airways) in the lungs that causes coughing. Bronchitis usually begins as an infection in the nose, ears, throat, or sinuses. The infection then makes its way down to the bronchi. ...
,
coronary artery disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic pl ...
and atypical pneumonia in addition to several other possible diseases.


Life cycle and method of infection

''Chlamydia pneumoniae'' is a small gram-negative bacterium (0.2 to 1
μm The micrometre ( international spelling as used by the International Bureau of Weights and Measures; SI symbol: μm) or micrometer ( American spelling), also commonly known as a micron, is a unit of length in the International System of Uni ...
) that undergoes several transformations during its life cycle. It exists as an
elementary body Elementary may refer to: Arts, entertainment, and media Music * ''Elementary'' (Cindy Morgan album), 2001 * ''Elementary'' (The End album), 2007 * ''Elementary'', a Melvin "Wah-Wah Watson" Ragin album, 1977 Other uses in arts, entertainment, an ...
(EB) between hosts. The EB is not biologically active, but is resistant to
environment Environment most often refers to: __NOTOC__ * Natural environment, all living and non-living things occurring naturally * Biophysical environment, the physical and biological factors along with their chemical interactions that affect an organism or ...
al stresses and can survive outside a host for a limited time. The EB travels from an infected person to the
lung The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of ...
s of an uninfected person in small
droplet A drop or droplet is a small column of liquid, bounded completely or almost completely by free surfaces. A drop may form when liquid accumulates at the lower end of a tube or other surface boundary, producing a hanging drop called a pendant ...
s and is responsible for infection. Once in the lungs, the EB is taken up by
cell Cell most often refers to: * Cell (biology), the functional basic unit of life Cell may also refer to: Locations * Monastic cell, a small room, hut, or cave in which a religious recluse lives, alternatively the small precursor of a monastery ...
s in a pouch called an
endosome Endosomes are a collection of intracellular sorting organelles in eukaryotic cells. They are parts of endocytic membrane transport pathway originating from the trans Golgi network. Molecules or ligands internalized from the plasma membrane can ...
by a process called
phagocytosis Phagocytosis () is the process by which a cell uses its plasma membrane to engulf a large particle (≥ 0.5 μm), giving rise to an internal compartment called the phagosome. It is one type of endocytosis. A cell that performs phagocytosis is ...
. However, the EB is not destroyed by fusion with
lysosome A lysosome () is a membrane-bound organelle found in many animal cells. They are spherical vesicles that contain hydrolytic enzymes that can break down many kinds of biomolecules. A lysosome has a specific composition, of both its membrane p ...
s, as is typical for phagocytosed material. Instead, it transforms into a
reticulate body Reticulation is a net-like pattern, arrangement, or structure. Reticulation or Reticulated may refer to: * Reticulation (single-access key), a structure of an identification tree, where there are several possible routes to a correct identificat ...
(RB) and begins to replicate within the endosome. The reticulate bodies must use some of the host's cellular metabolism to complete its replication. The reticulate bodies then convert back to elementary bodies and are released back into the lung, often after causing the death of the host cell. The EBs are thereafter able to infect new cells, either in the same
organism In biology, an organism () is any living system that functions as an individual entity. All organisms are composed of cells ( cell theory). Organisms are classified by taxonomy into groups such as multicellular animals, plants, and fu ...
or in a new host. Thus, the lifecycle of ''C. pneumoniae'' is divided between the elementary body, which is able to infect new hosts but cannot replicate, and the reticulate body, which replicates but is not able to cause a new infection.


Diseases

''Chlamydia pneumoniae'' is a common cause of pneumonia around the world; it is typically acquired by otherwise-healthy people and is a form of
community-acquired pneumonia Community-acquired pneumonia (CAP) refers to pneumonia (any of several lung diseases) contracted by a person outside of the healthcare system. In contrast, hospital-acquired pneumonia (HAP) is seen in patients who have recently visited a hospital ...
. Its treatment and diagnosis are different from historically recognized causes, such as ''
Streptococcus pneumoniae ''Streptococcus pneumoniae'', or pneumococcus, is a Gram-positive, spherical bacteria, alpha-hemolytic (under aerobic conditions) or beta-hemolytic (under anaerobic conditions), aerotolerant anaerobic member of the genus Streptococcus. They ar ...
''. Because it does not gram stain well, and because ''C. pneumoniae'' bacteria is very different from the many other bacteria causing pneumonia (in the earlier days, it was even thought to be a virus), the pneumonia caused by ''C. pneumoniae'' is categorized as an " atypical pneumonia". One
meta-analysis A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting m ...
of
serological Serology is the scientific study of serum and other body fluids. In practice, the term usually refers to the diagnostic identification of antibodies in the serum. Such antibodies are typically formed in response to an infection (against a given mic ...
data comparing prior ''C. pneumoniae'' infection in patients with and without lung cancer found results suggesting prior infection was associated with an increased risk of developing lung cancer. In research into the association between ''C. pneumoniae'' infection and
atherosclerosis Atherosclerosis is a pattern of the disease arteriosclerosis in which the wall of the artery develops abnormalities, called lesions. These lesions may lead to narrowing due to the buildup of atheromatous plaque. At onset there are usually no s ...
and
coronary artery disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic pl ...
,
serological Serology is the scientific study of serum and other body fluids. In practice, the term usually refers to the diagnostic identification of antibodies in the serum. Such antibodies are typically formed in response to an infection (against a given mic ...
testing, direct pathologic analysis of plaques, and ''in vitro'' testing suggest infection with ''C. pneumoniae'' is a significant risk factor for development of atherosclerotic
plaque Plaque may refer to: Commemorations or awards * Commemorative plaque, a plate or tablet fixed to a wall to mark an event, person, etc. * Memorial Plaque (medallion), issued to next-of-kin of dead British military personnel after World War I * Pl ...
s and atherosclerosis. ''C. pneumoniae'' infection increases adherence of
macrophages Macrophages (abbreviated as M φ, MΦ or MP) ( el, large eaters, from Greek ''μακρός'' (') = large, ''φαγεῖν'' (') = to eat) are a type of white blood cell of the immune system that engulfs and digests pathogens, such as cancer ce ...
to
endothelial cells The endothelium is a single layer of squamous endothelial cells that line the interior surface of blood vessels and lymphatic vessels. The endothelium forms an interface between circulating blood or lymph in the lumen and the rest of the vessel ...
''in vitro'' and aortas ''ex vivo''. However, most current research and data are insufficient and do not define how often ''C. pneumoniae'' is found in atherosclerotic or normal
vascular The blood vessels are the components of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide away f ...
tissue. ''Chlamydia pneumoniae'' has also been found in the cerebrospinal fluid of patients diagnosed with multiple sclerosis. ''Chlamydia pneumoniae'' infection was first associated with wheezing, asthmatic bronchitis, and adult-onset asthma in 1991. Subsequent studies of bronchoalveolar lavage fluid from pediatric patients with asthma and also other severe chronic respiratory illnesses have demonstrated that over 50 percent had evidence of C. pneumoniae by direct organism identification. C. pneumoniae infection triggers acute wheezing, if it becomes chronic then it is diagnosed as asthma. These observations suggest that acute ''C. pneumoniae'' infection is capable of causing protean manifestations of chronic respiratory illness which lead to asthma. Macrolide antibiotic treatment can improve asthma in a subgroup of patients that remains to be clearly defined. Macrolide benefits were first suggested in two observational trials and two randomized controlled trials of azithromycin treatment for asthma. One of these RCTs and another macrolide trial suggest that the treatment effect may be greatest in patients with severe, refractory asthma. These clinical results correlate with epidemiological evidence that ''C. pneumoniae'' is positively associated with asthma severity and laboratory evidence that ''C. pneumoniae'' infection creates steroid-resistance. A meta analysis of 12 RCTs of macrolides for the long term management of asthma found significant effects on asthma symptoms, quality of life, bronchial hyper reactivity and peak flow but not FEV1. More recent positive results of long-term treatment with azithromycin on asthma exacerbations and quality-of-life in patients with severe, refractory asthma have resulted in azithromycin now being recommended in international guidelines as a treatment option for these types of patients. A recent case series of 101 adults with asthma reported that macrolides (mostly azithromycin) and tetracyclines, either separately or in combination, appeared to be dramatically efficacious in a subgroup of "difficult-to-treat" (i.e., not necessarily refractory to high-dose inhaled corticosteroids but who did not take them) patients with severe asthma, many of whom also had the "overlap syndrome" (asthma and COPD). Randomized, controlled trials that include these types of asthma patients are needed. ''Chlamydia pneumoniae'' infection is also associated with schizophrenia. Many other pathogens have been associated with schizophrenia.


Vaccine research

There is currently no vaccine to protect against ''Chlamydia pneumoniae''. Identification of immunogenic
antigen In immunology, an antigen (Ag) is a molecule or molecular structure or any foreign particulate matter or a pollen grain that can bind to a specific antibody or T-cell receptor. The presence of antigens in the body may trigger an immune respon ...
s is critical for the construction of an efficacious subunit vaccine against ''C. pneumoniae'' infections. Additionally, there is a general shortage worldwide of facilities that can identify/diagnose ''Chlamydia pneumoniae''.


References


External links


Chlamydia Pneumoniae cpnhelp.org

Type strain of ''Chlamydopila pneumoniae'' at Bac''Dive'' - the Bacterial Diversity Metadatabase
{{Authority control Chlamydiota Infectious causes of cancer