Haller E M, Auer-Grumbach P, Stuenzner D, Kessler H H, Pierer K, Muellner K, Zenz H
Department of Ophthalmology, Karl-Franzens-University, Graz, Austria.
Ophthalmology. 1997 Jan;104(1):125-30. doi: 10.1016/s0161-6420(97)30350-9.
The antibody response in sera and tears of 167 patients with suspected chlamydial conjunctivitis was compared with the antibody response in sera and tears of 45 patients with symptoms of urogenital chlamydial infection to discover whether and which type of antichlamydial antibody detected in tears may be of diagnostic help in chlamydial conjunctivitis.
Diagnosis was based on chlamydial antigen detection from the conjunctiva and urogenital tract, done by a direct immunofluorescence assay, McCoy cell culture, and polymerase chain reaction. Additionally, antichlamydial immunoglobulin A (IgA) and immunoglobulin G (IgG) were determined in sera and tears of all patients by an immunoperoxidase assay.
Two hundred twelve patients were examined--167 with conjunctivitis, 45 with symptoms of urogenital chlamydial infection. Cell culture, direct immunofluorescence assay, and polymerase chain reaction brought identical results. Conjunctival specimens taken from 33 (20%) of the patients with conjunctivitis were Chlamydia antigen positive; specimens taken from 134 (80%) were negative. Antichlamydial antibodies were found in tears of 29 (88%) of the patients with conjunctivitis whose specimens were Chlamydia antigen positive. Fifty-four (40%) of the patients with conjunctivitis whose specimens were Chlamydia antigen negative had antichlamydial antibodies in their tears. Twenty-five patients with urethritis (56%) were Chlamydia antigen positive in urethral swabs; 20 (44%) were negative. Antichlamydial antibodies were found in the tears of eight (32%) of the Chlamydia antigen-positive and two (10%) of the Chlamydia antigen-negative patients with urethritis. In contrast to patients with conjunctivitis, findings for patients with urethritis always were negative for antichlamydial IgG in the tears.
Antichlamydial antibodies in tears were seen significantly more often in patients with conjunctivitis than in those with urethritis (P < or = 0.05). Antichlamydial IgG was found only in tears of patients with conjunctivitis. Therefore, the authors conclude that the detection of antichlamydial IgG in the tears might be helpful for diagnosis in patients with suspected chlamydial conjunctivitis who have antigen-negative conjunctival swabs.
比较167例疑似衣原体性结膜炎患者血清和泪液中的抗体反应与45例有泌尿生殖系统衣原体感染症状患者血清和泪液中的抗体反应，以确定泪液中检测到的抗衣原体抗体是否以及哪种类型对衣原体性结膜炎有诊断帮助。
诊断基于通过直接免疫荧光测定、McCoy细胞培养和聚合酶链反应从结膜和泌尿生殖道检测衣原体抗原。此外，通过免疫过氧化物酶测定法测定所有患者血清和泪液中的抗衣原体免疫球蛋白A（IgA）和免疫球蛋白G（IgG）。
共检查了212例患者——167例结膜炎患者，45例有泌尿生殖系统衣原体感染症状的患者。细胞培养、直接免疫荧光测定和聚合酶链反应结果相同。从33例（20%）结膜炎患者采集的结膜标本衣原体抗原呈阳性；从134例（80%）采集的标本呈阴性。在标本衣原体抗原呈阳性的29例（88%）结膜炎患者的泪液中发现了抗衣原体抗体。54例（40%）标本衣原体抗原呈阴性的结膜炎患者泪液中有抗衣原体抗体。25例尿道炎患者（56%）尿道拭子衣原体抗原呈阳性；20例（44%）呈阴性。在衣原体抗原呈阳性的8例（32%）尿道炎患者和2例（10%）衣原体抗原呈阴性的尿道炎患者的泪液中发现了抗衣原体抗体。与结膜炎患者不同，尿道炎患者泪液中的抗衣原体IgG检测结果始终为阴性。
结膜炎患者泪液中的抗衣原体抗体明显多于尿道炎患者（P≤0.05）。仅在结膜炎患者的泪液中发现了抗衣原体IgG。因此，作者得出结论，对于结膜拭子抗原阴性的疑似衣原体性结膜炎患者，检测泪液中的抗衣原体IgG可能有助于诊断。
