Chlamydia psittaci is variably associated with ocular adnexal MALT lymphoma in different geographical regions

Abstract

Infectious agents play a critical role in MALT lymphoma development. Studies from Italy showed Chlamydia psittaci infection in 87% of ocular adnexal MALT lymphomas and complete or partial regression of the lymphoma after C. psittaci eradication in four of nine cases. However, C. psittaci was not demonstrated in ocular adnexal MALT lymphomas from the USA. This study was thus designed to investigate further the role of C. psittaci, and other infectious agents commonly associated with chronic eye disease, in the development of ocular adnexal MALT lymphoma. The presence of C. psittaci, C. trachomatis, C. pneumoniae, herpes simplex virus 1 and 2 (HSV1, HSV2), and adenovirus 8 and 19 (ADV8, ADV19) was assessed separately by polymerase chain reaction in 142 ocular adnexal MALT lymphomas, 53 non-marginal zone lymphomas, and 51 ocular adnexal biopsies without a lymphoproliferative disorder (LPD), from six geographical regions. C. psittaci was detected at similar low frequencies in non-LPD and non-marginal zone lymphoma groups from different geographical regions (0-14%). Overall, the prevalence of C. psittaci was significantly higher in MALT lymphomas (22%) than in non-LPD (10%, p=0.042) and non-marginal zone lymphoma cases (9%, p=0.033). However, the prevalence of C. psittaci infection in MALT lymphoma showed marked variation among the six geographical regions examined, being most frequent in Germany (47%), followed by the East Coast of the USA (35%) and the Netherlands (29%), but relatively low in Italy (13%), the UK (12%), and Southern China (11%). No significant differences in the detection of C. pneumoniae, C. trachomatis, HSV1, HSV2, ADV8, and ADV19 were found between lymphomas and controls from different geographical regions. In conclusion, our results show that C. psittaci, but not C. pneumoniae, C. trachomatis, HSV1, HSV2, ADV8 or ADV19, is associated with ocular adnexal MALT lymphoma and that this association is variable in different geographical areas.

Chlamydiae and Mycoplasma infections in pulmonary MALT lymphoma

“…DNA was purified from whole tissue sections, and checked for integrity by multiplex PCR amplification of variously sized human gene fragments (100, 200, 300 and 400 bp) (Chanudet et al, 2006). Of the 159 cases, 143 had adequate materials as judged by quality control PCR and were thus suitable for PCR-based screening of microbial pathogens.…”

“…The detection of C. psittaci, C. pneumoniae and C. trachomatis was carried out separately using a previously described Touchdown PCR (Chanudet et al, 2006). Mycoplasma pneumoniae was detected by PCR of the Mycoplasma-associated P1 adhesion protein gene as described previously (Hardegger et al, 2000).…”

“…Positive PCR products were purified and sequenced using an ABI 377 DNA sequencer (ABI PRISM Perkin Elmer) to confirm the specificity of PCR. In each case, three independent PCRs were carried out for each microbial species and only cases with positive PCR results in at least two of the three independent reactions were regarded as positive (Ferreri et al, 2004;Chanudet et al, 2006). Differences in the prevalence of infectious agents among various lymphoma subtypes and controls were analysed using Fisher's exact test ('stats Package' in R version 2.1.1).…”

“…Borrelia burgdorferi and Campylobacter jejuni are associated with cutaneous marginal zone B-cell lymphoma and immunoproliferative small intestinal disease, respectively (Cerroni et al, 1997;Lecuit et al, 2004). Recent studies show that Chlamydia psittaci is variably associated with ocular adnexal MALT lymphoma in different geographical regions (Ferreri et al, 2004;Chanudet et al, 2006) and eradication of the organism results in complete regression of the lymphoma in some cases (Ferreri et al, 2005).…”

Extranodal and splenic small B-cell lymphoma

“…In some organs, the stimulus for the acquisition of MALT is known such as Helicobacter pylori in the stomach, 5 Hashimoto's thyroiditis in the thyroid 6 and Sjö gren's disease in the salivary glands. 7 In other cases, the underlying stimulus is suspected for at least a proportion of the cases (Borrelia burgdorferi in the skin, 8 Chlamydia psittaci in the conjunctive 9 ) but for the remainder the underlying association remains enigmatic.…”