Abstract
Microbial infection and associated super antigens have been implicated in the pathogenesis of CTCL, and many patients die from complicating bacterial infections. It has been postulated that Chlamydophila pneumoniae infection may be involved in the pathogenesis of Mycosis fungoides (MF) but published data are limited and controversial. Aim of the study: The aim of the study was to analyze the frequency of C. pneumoniae DNA presence in blood samples of cutaneous T-cell and B-cell lymphomas (CTCL, CBCL) cases. Material and Methods: Using Q-PCR method we analyzed the presence of C. pneumoniae DNA in the blood samples obtained from 57 patients with CTCL (55-MF/Sezary Syndrome (SS), 1-primary cutaneous anaplastic large cell lymphoma (CD30+) and 1-NKT cell lymphoma) and 3 patients with cutaneous B-cell lymphomas and 120 individuals from control groups (40 patients with psoriasis, 40 patients with atopic dermatitis and 40 healthy controls). Results: C. pneumoniae DNA was identified in 13 of 55 cases in MF/SS group (23, 6%), in one patient with CD30+ large cell lymphoma and in 1 of 3 patients with B-cell lymphoma. The presence of C. pneumoniae was confirmed in 1 of 40 psoriatic patients (2, 5%), in 5 of 40 patients with atopic dermatitis (12, 5%) and in none of 40 healthy individuals. The frequency of C. pneumoniae DNA occurrence in MF patients group was strongly associated with the progression of the disease; rs = 0.756; p=0.0123 for groups IA→IVB, also for MF + SS patients divided by stages, the presence of C. pneumoniae was noted more frequently in advanced (III + IV) stages than in early (I-II) stages (p=0.0139). There are no differences in the main age of MF/SS patients with and without infection. Conclusion: Our results indicated that the presence of C. pneumoniae DNA in the blood cells is frequent event in late stages of MF/SS and may be explained by Th2 shift and suppression of immune system during the course of the disease.
Highlights
Antigen stimulation by pathogens such as bacteria’s and viruses has been considered as possible predisposing factor to uncontrolled cell proliferation and development of lymphoid and other tissue neoplastic
Our results indicated that the presence of C. pneumoniae Deoxyribonucleic Acid (DNA) in the blood cells is frequent event in late stages of Mycosis fungicides (MF)/Sézary syndrome (SS) and may be explained by Th2 shift and suppression of immune system during the course of the disease
It has been suggested that C. pneumoniae infection may stimulate the IL-10 production which down regulates the expression of major histocompatibility complex class I (MHC-I), inhibits apoptosis and increases the longevity of the host cell, enhancing the survival of bacteria itself [22,23]
Summary
Antigen stimulation by pathogens such as bacteria’s and viruses has been considered as possible predisposing factor to uncontrolled cell proliferation and development of lymphoid and other tissue neoplastic. It has been suggested that C. pneumoniae infection may stimulate the IL-10 production which down regulates the expression of major histocompatibility complex class I (MHC-I), inhibits apoptosis and increases the longevity of the host cell, enhancing the survival of bacteria itself [22,23]. It has been suspected that a localized bacterial infection increases local production of inflammatory cytokines including interferon gamma (IFN-γ) (critical in immunity and immunopathology of chlamydial infection) and CXCL-10, a cytokine chemo attractive for epidermotropic T lymphocytes [24] Studies on the growth requirements of the abnormal T lymphocytes in MF/SS lead to the identification of a so-called Sézary cell activation factor (SAF) that stimulates the growth of both malignant and non-malignant T cells. The authors showed that C. pneumoniae antigen expression was associated with active disease and was not found after psoralen and ultraviolet a therapy
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