WESTPORT, CT (Reuters Health) Nov 30 - A fastidious, but futile, search for Chlamydia pneumoniae in the brains of multiple sclerosis patients suggests that the organism is not involved in inflammatory demyelination, according to results published in the November Journal of Clinical Microbiology.
Although C. pneumoniae is one of several infectious agents proposed to cause MS, studies seeking its presence in brain and cerebrospinal fluid have yielded conflicting results, the authors note.
Dr. Margaret R. Hammerschlag, from SUNY Health Science Center in Brooklyn, New York, and colleagues tested brain tissue from 25 patients with MS, 11 patients with nonneurological diseases, and 5 patients with other neurological diseases for the presence of C. pneumoniae, using culture and polymerase chain reaction techniques.
All brain specimens submitted for C. pneumoniae culture yielded negative results, the report indicates, even after four passages in HEp-2 cells.
All 81 brain tissue samples (and synovial cells from rheumatoid arthritis patients) were negative for C. pneumoniae DNA by PCR, the authors report. A second round of PCR, capable of detecting as few as six bacterial organisms in the positive control, failed to identify a single positive sample.
"Our studies on brain tissues do not confirm the recent identification of C. pneumoniae in the CSF of MS patients," the authors conclude. "These conflicting observations, appearing in increasing numbers not only in the MS literature but also in the literature of Alzheimer's disease, rheumatoid arthritis, and atherosclerosis, reflect the existence of methodological difficulties which urgently require a solution."
"It is very difficult to make any conclusion about the involvement of a microorganism in a pathological condition without a standardized methodology," study co-author Dr. Bernadette Kalman, from MCP Hahnemann University in Philadelphia, Pennsylvania, told Reuters Health.
"Sadly," she said, "the C. pneumoniae controversy in MS prompts many labs to invest time and money to pursue this question, the focus of research is shifted, and patients may have unrealistic hope in regard to therapy. It has become a very important question, and needs to be sorted out."
J Clin Microbiol 2000;38:4274-4276.
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