To mimic in vivo conditions during chlamydial infections, Chlamydia trachomatis serovar D and Chlamydia pneumoniae CWL029 were cultured in low-oxygen atmospheres containing 4% O 2 , with parallel controls cultured in atmospheric air. Both were enriched with 5% CO 2 . The results showed a dramatic increase in the growth of C. pneumoniae but not of C. trachomatis.The chlamydial developmental cycle is biphasic, alternating between an infectious metabolically inactive elementary body (EB) specialized for extracellular survival and a noninfectious proliferating intracellular reticulate body (RB). During the course of an infection, the EB is endocytosed by a susceptible host cell into a host-derived vacuole, the chlamydial inclusion. After internalization, the EB develops into an RB, which proliferates by binary fission. Following several rounds of proliferation lasting 48 to 72 h, RBs transform into EBs and are released by the disruption of the host cell (for a review, see reference 9).Chlamydia trachomatis is an obligate human pathogen causing ocular and genital infections. Chlamydia pneumoniae causes respiratory tract infections, often asymptomatic, but may cause bronchitis and pneumonia (5). Traditionally, both C. trachomatis and C. pneumoniae have been studied in vitro by infecting cell culture monolayers and incubating the infected cells in incubators in a humid atmosphere containing atmospheric air enriched with 5% CO 2 , resulting in an oxygen concentration of approximately 20%. However, the in vivo oxygen tension is much lower, generally in the range of 3 to 6% (Table 1), and as different tissues have different oxygen requirements, the in vivo oxygen tension may vary considerably from tissue to tissue. The oxygen requirements of Chlamydia have never been evaluated before, but it is known that the oxygen tension of host tissue is important for viral replication and the viral life cycle (3) and that many infecting microorganisms are microaerophilic. As Chlamydia proliferates in vivo where the oxygen tension varies between different tissues, it is plausible that Chlamydia is also affected by the oxygen tension and would experience enhanced growth in tissues with optimum oxygen tension.C. trachomatis and C. pneumoniae produced enlarged inclusions in 4% oxygen. To determine the visible effect of low oxygen tension on chlamydial inclusions, infected HeLa cells were cultured on coverslips at 4% and 20% O 2 . HeLa 229 cells (ATCC, Rockville, MD) cultured in 24-well trays (TPP, Trasadingen, Switzerland) were infected with either C. trachomatis serovar D/UW-3/CX (ATCC) or C. pneumoniae CWL029 (ATCC) as previously described (12, 15) and cultured in the presence of cycloheximide in either 4% or 20% oxygen atmospheres. Low-oxygen atmospheres were achieved by placing trays with infected HeLa cells in an airtight custom-made box (40 by 30 by 16 cm [width by diameter by height]). An OX-500 Clark-type oxygen sensor (UniSense, Aarhus, Denmark) was placed inside the box to measure the oxygen concentration. The box was flushed w...