Ci-dessous l'abstarct d'un article qui explique que ces data contradictoires sont proabablement d'orgine technique (difficulté de mettre le germe, Chlamydia pneumoniae en évidence), et décrit donc une métholodologie devant permettre d'avancer significativement dans ce domaine.
Personellement je ne suis, pour le moment, pas du tout convaincu sur le rôle de C. pneumoniae dans cette pathologie. De même que je ne l'était pas quand les premières études l'incriminant dans athérosclérose (donc infarctus du myocarde et cie) sont sorties. Et elles ne sont toujours pas confirmées, au contraire, au jour d'aujourd'hui
Mais j'espère vraiment avoir tort car les infections à Chlamydia, ça on sait traiter. Et efficacement. Alors que la SEP....
PLoS ONE. 2009;4(4):e5200. Epub 2009 Apr 9.
Qualitative and quantitative detection of Chlamydophila pneumoniae DNA in cerebrospinal fluid (c'est à dire le Liquide céphalo rachidien) from multiple sclerosis patients and controls.
Tang YW, Sriram S, Li H, Yao SY, Meng S, Mitchell WM, Stratton CW.
Department of Pathology, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America. yiwei.tang@vanderbilt.edu
A standardized molecular test for the detection of Chlamydophila pneumoniae DNA in cerebrospinal fluid (CSF) would assist the further assessment of the association of C. pneumoniae with multiple sclerosis (MS). We developed and validated a qualitative colorimetric microtiter plate-based PCR assay (PCR-EIA) and a real-time quantitative PCR assay (TaqMan) for detection of C. pneumoniae DNA in CSF specimens from MS patients and controls. Compared to a touchdown nested-PCR assay, the sensitivity, specificity, and concordance of the PCR-EIA assay were 88.5%, 93.2%, and 90.5%, respectively, on a total of 137 CSF specimens. PCR-EIA presented a significantly higher sensitivity in MS patients (p = 0.008) and a higher specificity in other neurological diseases (p = 0.018). Test reproducibility of the PCR-EIA assay was statistically related to the volumes of extract DNA included in the test (p = 0.033); a high volume, which was equivalent to 100 microl of CSF per reaction, yielded a concordance of 96.8% between two medical technologists running the test at different times. The TaqMan quantitative PCR assay detected 26 of 63 (41.3%) of positive CSF specimens that tested positive by both PCR-EIA and nested-PCR qualitative assays. None of the CSF specimens that were negative by the two qualitative PCR methods were detected by the TaqMan quantitative PCR. The PCR-EIA assay detected a minimum of 25 copies/ml C. pneumoniae DNA in plasmid-spiked CSF, which was at least 10 times more sensitive than TaqMan. These data indicated that the PCR-EIA assay possessed a sensitivity that was equal to the nested-PCR procedures for the detection of C. pneumoniae DNA in CSF. The TaqMan system may not be sensitive enough for diagnostic purposes due to the low C. pneumoniae copies existing in the majority of CSF specimens from MS patients.