急性冠脉综合征患者血清肺炎衣原体、 人巨细胞病毒感染的血清学研究

目的　探讨急性冠脉综合征与肺炎衣原体、人巨细胞病毒感染之间的关系。方法　对 42例急性心肌梗死(AMI)患者、43例不稳定心绞痛 (UAP)患者和 33例健康对照者采用微量免疫荧光法 (Micro IFA)检测血清中肺炎衣原体特异性抗体IgG、IgM及其滴度 ,用间接酶联免疫吸附测定法测定血清中人巨细胞病毒抗体IgG和IgM。结果　三组研究对象中均未检出急性肺炎衣原体感染者。急性心肌梗死、不稳定心绞痛组和正常对照组肺炎衣原体慢性感染率分别为6 6 7%、6 2 8%和 36 4% ,其中急性心肌梗死组、不稳定心绞痛组肺炎衣原体慢性感染率均较对照组升高 ,有统计学差异(P <0 0 5 )。上述三组平均肺炎衣原体特异性抗体滴度分别为 1 42、1 37和 0 88,急性心肌梗死组较正常对照组升高 ,有显著性差异 (P <0 0 1)。不稳定心绞痛组较正常对照组升高 ,有统计学差异 (P <0 0 5 )。此外 ,急性心肌梗死组与不稳定心绞痛组之间肺炎衣原体慢性感染率及平均IgG滴度无统计学差异 (P >0 0 5 )。三组研究对象中仅检出 1例抗人巨细胞病毒抗体IgM阳性者 ,IgG阳性率分别为 34 2 %、2 1 6 %和 41 9% ,无统计学差异。结论　肺炎衣原体慢性感染与急性冠脉综合征之间存在一定的联系 ,人巨细胞病毒感染与急性冠脉综合征之间的关系仍需进一步的     

Serological evidence of Chlamydia pneumoniae lipopolysaccharide antibodies in atherosclerosis of various vascular regions

BACKGROUND: The role of Chlamydia pneumoniae in the pathogenesis of atherosclerosis has so far mainly been investigated in patients suffering from coronary heart disease; the other vascular regions have virtually been ignored. The aim of this study was to carry out a statistical survey of serological markers of a C. pneumoniae infection in patients with different patterns of atherosclerosis manifestation. PATIENTS AND METHODS: 340 patients were examined for the atherosclerotic alteration of peripheral arteries of the lower limbs, carotid arteries and coronary arteries by ultrasound scan and/or angiography. Immunoglobulin(Ig)G and IgA-rELISA were used to measure chlamydial lipopolysaccharide antibodies. Species determination was performed using the IgG micro-immunofluorescence test. RESULTS: 24.0% of atherosclerotic cases (A) and 52.3% of controls (C) were negative for C. pneumoniae lipopolysaccharide antibodies (p = 0.00002). By contrast, 45.1% of atherosclerotic cases and 16.9% of controls were positive for both IgG and IgA (p = 0.00002). The mean antibody titers of the atherosclerosis group were higher than in the control group (IgG positive xAIgG = 344, xCIgG = 272; IgG and IgA positive xAIgG = 576, xCIgG = 486 and xAIgA = 120, xCIgA = 91). Concerning atherosclerosis manifestation in various vascular regions, no significant differences were found between IgG and IgA antibody titers and prevalence. CONCLUSIONS: The results show that a persistent C, pneumoniae infection with evidence of lipopolysaccharide immunoglobulin G and A is equally associated with the atherosclerotic alteration of coronary arteries, carotid arteries and peripheral arterial occlusive disease, irrespective of the severity of atherosclerosis and with no predisposition to any particular vascular region.     

Possible role of chronic infection with Chlamydia pneumoniae in Japanese patients with acute myocardial infarction

Chlamydia pneumoniae, a common human respiratory pathogen, has been implicated in the pathogenesis of coronary heart diseases (CHD) in several seroepidemiological studies. The present case-control study investigated the relation between serologic evidence of C. pneumoniae infection and CHD in a Japanese population. Two groups of cases were enrolled: 26 patients with acute myocardial infarction (AMI) and 46 patients with effort angina pectoris (e-AP). Their data were compared with 58 age-matched healthy controls and also compared with 53 patients with vasospastic angina (VSA) as pathological control subjects. Anti-C. pneumoniae specific IgA and IgG antibody titers were measured by enzyme-linked immunosorbent assay (ELISA). The mean indices of IgG-type antibody in AMI and e-AP were not significantly different from those in either the normal controls or VSA group. On the other hand, the mean indices of IgA-type antibody in AMI were significantly higher than in the normal controls (1.39+/-0.83 in AMI vs 0.84+/-0.58 in controls, p<0.001) and VSA (1.39+/-0.83 in AMI vs 1.05+/-0.61 in VSA, p<0.05) group. However, the differences in the IgA titers in the e-AP group compared with the normal controls did not reach a significant level. The odds ratio associated with the seropositivity of IgA for AMI against the normal controls was 3.89 (95% confidence interval (CI): 1.16-13.10) and that against VSA was 6.90 (95% CI: 1.73-27.52) after adjustment for risk factors for CHD and/or age, sex and smoking status. In 6 patients the elevated IgA titers were sustained even at 3 months after the episode of AMI. These results suggest that seropositivity for IgA-type antibody against C. pneumoniae may be a significant risk factor for the development of AMI. The possible mechanisms include chronic inflammation in the coronary artery due to persistent C. pneumoniae infection.     

肺炎衣原体感染对冠心病发病影响的临床观察

目的 研究肺炎衣原体(Cpn)感染与冠心病(CHD)的关系.方法 应用酶联免疫吸附试验(ELISA)测定冠心病组(120例)和对照组(111例)血清Cpn特异性抗体IgM、IgG及IgA,同时应用免疫浊度法测定冠心病组(97例)和对照组(95例)血清C-反应蛋白(CRP)含量.结果 冠心病组血清Cpn抗体IgG和/或IgA阳性率及IgG和IgA滴度明显高于对照组(均P<0.05);急性心肌梗死(AMI)、不稳定型心绞痛(UAP)及慢性冠心病(CCHD)患者血清Cpn抗体IgG及IgA滴度均分别高于对照组(均P<0.05);冠心病组Cpn抗体IgM阳性率及滴度与对照组无明显差异;IgG和/或IgA及CRP均为阳性组的冠心病发生率明显增高;多元回归分析显示Cpn慢性感染与冠心病发病呈正相关(P=0.045),Cpn慢性感染与冠心病其他危险因素间无相关性.结论Cpn慢性感染可作为冠心病的独立危险因素,炎症反应的发生可能是Cpn慢性感染导致动脉粥样硬化的关键环节.     

Relation of secretory phospholipase A(2) and high-sensitivity C-reactive protein to Chlamydia pneumoniae infection in acute coronary syndromes.

BACKGROUND: Recently it has become clear that inflammatory changes play a part in the development of atherosclerosis, including coronary artery disease, and Chlamydia pneumoniae (C. pneumoniae) is thought to be a proinflammatory factor. The plasma concentration of high-sensitive C-reactive protein (hs-CRP) is a potential predictor of outcome in atherosclerotic diseases. Recent interest has focused on secretory group IIA phospholipase A(2) (sPLA (2)) in regard to the progression of atherosclerotic disease. METHODS AND RESULTS: The concentrations of sPLA(2), hs-CRP, and the titers of C. pneumoniae IgG and IgA antibodies were measured in blood samples. The study groups were an acute coronary syndrome (ACS) group, old myocardial infarction/angina pectoris (OMI/AP) group, and a control group. The concentrations of sPLA(2) and hs-CRP in the ACS group and the OMI/AP group were higher than in the control group. The titers of C. pneumoniae IgG and IgA were higher in the ACS group than in the control group. The sPLA(2) concentration was higher in those who were positive to C. pneumoniae IgG/IgA than in those who were negative. CONCLUSION: Increased concentrations of sPLA(2) reflect participation in the progression of coronary artery disease. The sPLA(2) concentration was higher in patients positive for C. pneumoniae than in those negative for C. pneumoniae, so C. pneumoniae infection poses a greater risk for ACS in those individuals than in those who are free of such infection.     

微量免疫荧光标记法检测冠心病患者血清肺炎衣原体抗体

目的　测定冠心病患者的血清肺炎衣原体特异性抗体 ,探讨其临床价值。方法　应用间接微量免疫荧光标记法对 2 0 5例体检健康人群和 170例住院确诊的冠心病患者进行肺炎衣原体特异性抗体 Ig G、Ig M的检测。结果　体检健康人群 Ig G总阳性率 2 1.5 % ;均阴性 ;冠心病患者 Ig G总阳性率为 91.2 % ,Ig M阳性率为 5 % ,其中无症状型冠心病组、不稳定型心绞痛组及急性心肌梗死组肺炎衣原体总感染率分别为 96 .2 %、86 %、88.1% ,既往感染率分别为 76 .9%、6 2 .0 %、71.4 % ,急性感染率分别为 19.2 %、2 4 .0 %、16 .7%。总感染率、既往感染率及急性感染率冠心病组较健康人群组明显增高 (优势比分别为 4 .14、2 .88、19.2 4 ,95 %的可信区间分别为 3.18～ 5 .39、2 .2 1～ 3.74、2 .79～ 132 .6 7)。结论　微量免疫荧光标记法系目前冠心病患者血清检测肺炎衣原体特异性抗体 ,从而确定肺炎衣原体感染的一个敏感度高、特异性强 ,简单易行的方法之一。     

Evidence of chronic Chlamydia pneumoniae infection in patients with Behçet's disease

Beh?et's disease is a chronic vasculitis of unknown aetiology. Particular viral and bacterial pathogens have long been suspected of playing a role in the pathogenesis of the disease. Chlamydia pneumoniae is an intracellular bacterium capable of causing chronic infections. Some reports have suggested that the microorganism might be involved in the pathogenesis of vasculitis. The purpose of the present study was to investigate a possible correlation between C. pneumoniae infection and Beh?et's disease. For this purpose, 90 consecutive patients with Beh?et's disease and 50 healthy controls were enrolled. Immunoglobulin A (IgA) and IgG antibodies to C. pneumoniae were determined by 2 different techniques, namely indirect fluorescent antibody assay (IFA) and enzyme linked immunosorbent assay (ELISA). IgA antibodies to C. pneumoniae were detected in 17 (18.9%) patients with Beh?et's disease and in 1 (2%) healthy control by IFA. By ELISA 27 patients (30.0%) and 6 controls (12.0%) had C. pneumoniae IgA. A significant difference was observed for IgA seropositivity between the 2 groups. Although IgG seropositivity between the 2 groups did not differ significantly, the number of individuals with IgG titres of > or = 1:1000 was significantly higher in the patient group (43.1%) compared with the control group (13.9%). These finding provide serological evidence of chronic C. pneumoniae infection in association with Beh?et's disease.     

Relationship of Chlamydia pneumoniae infection to severity of coronary atherosclerosis in patients with chronic coronary artery disease and with normal coronary arteries]

OBJECTIVES: Recent studies have demonstrated an association between infection with Chlamydia (C.) pneumoniae and coronary artery disease. However, the association is less clear in the Japanese population. The relationship of C. pneumoniae infection to severity of coronary atherosclerosis was investigated in patients with chronic coronary artery disease and with normal coronary arteries. METHODS: Serum levels of IgA and IgG antibodies to C. pneumoniae outer membrane complex were measured by enzyme-linked immunosorbent assay and C-reactive protein (CRP) analyses in 130 patients who underwent coronary angiography. Patients with unstable angina and recent myocardial infarction were excluded. Results were divided into three groups according to Gensini coronary score (GCS): normal (n = 19, GCS = 0); mild atherosclerosis (n = 56, GCS = 1-19); and severe atherosclerosis (n = 55, GCS > or = 20). RESULTS: Cut off indices of IgA and IgG in the atherosclerosis groups (severe: 1.53 +/- 0.72 and 1.67 +/- 0.97, mild: 1.58 +/- 0.92 and 1.42 +/- 0.86, respectively) were higher than in the normal group (1.22 +/- 0.59 and 1.28 +/- 0.82), but there were no significant differences. There were no correlations between indices of IgA and IgG, and GCS. The normal CRP group (n = 118, < 0.3 mg/dl) and the high CRP group (n = 12, > or = 0.3 mg/dl) showed no differences in IgA and IgG indices and GCS. CONCLUSIONS: Serum antibody indices against C. pneumoniae are not associated with the severity of coronary atherosclerosis in chronic stable coronary artery disease.     

Chlamydia pneumoniae infection and its association with coronary heart disease and cardiovascular risk factors in a sample South Asian population.

Recent studies have suggested that a chronic infection with Chlamydia pneumoniae (C. pneumoniae) may be associated with the risk of developing coronary heart disease (CHD). A case control study was conducted to investigate the association between C. pneumoniae infection and coronary heart disease and coronary risk factors in a sample South Asian population. C. pneumoniae specific IgG antibody was measured by microimmunofluorescence. Among controls 56.6% were seropositive (> or =1/32) compared to 58.5% of acute myocardial infarction (AMI) patients (n=41, odds ratio 1.08, CI 0.37--3.12, P=0.93) and 73.3% of stable coronary heart disease (SCHD) patients (n=30, odds ratio 2.1, CI 0.63--7.19, P=0.27). The highest geometric mean titre of control subjects (n=30) was significantly lower (74.7) compared to AMI patients (101.5, P<0.05) and SCHD patients (138.6, P<0.05). Patients who were non-smokers had higher odds ratios for CHD than smokers when seropositive at IgG antibody titres of 1/32, 1/64 and 1/128, suggesting an association between smoking and C. pneumoniae infection. In patients with CHD there was a significant association between diabetes mellitus and seropositivity (P=0.008) in those over 50 years of age. Non-smoking CHD patients with high cholesterol/HDL-C ratio had a higher trend for seropositivity. Other risk factors (smoking, systolic and diastolic blood pressure, waist/hip ratio, triglycerides) showed no association when controlled for age. In the control group, smokers with high cholesterol/HDL-C ratio had a higher trend for seropositivity. These results do not provide strong support for the hypothesis that C. pneumoniae infection is a risk factor for clinical CHD in this South Asian population. Results suggest that C. pneumoniae infection may be linked to CHD through its interaction with some of the known risk factors such as blood lipids, diabetes and smoking.     

冠状粥动脉样硬化性疾病患者肺炎衣原体抗体检测

目的 为探索肺炎衣原体（Ｃｐｎ）和冠状动脉粥样硬化性心脏病之间的关系。方法 应用间接微量免疫荧光试验分别检测了６１例冠心病患者与６１例正常对照组血清中抗ＣｐｎＩｇＧ和ＩｇＭ抗体。结果 患者组ＩｇＧ抗体阳性率为７８．７％,对照组为５４．１％;ＩｇＭ抗体阳性率分别为２６．２％和６．６％。两组ＩｇＧ和ＩｇＭ抗体阳性率差异均有显著性（Ｐ〈０．０１）。此外,两组ＩｇＧ抗体的几何平均滴度差异尤具有显著性。结论     

Chlamydia pneumoniae seropositivity and systemic and renovascular atherosclerotic disease

BACKGROUND: Patients with hypertension may be vulnerable to vascular Chlamydia pneumoniae and/or cytomegalovirus (CMV) infection because of increased expression of adhesion molecules. OBJECTIVE: To determine whether C pneumoniae or CMV is associated with the presence of atherosclerotic lesions in hypertensive patients. METHODS: Ninety-six angiographic studies on 100 consecutive patients with of clinical signs or symptoms suggestive of renovascular hypertension were reviewed for the presence or absence of atherosclerotic lesions at the level of the renal arteries as well and abdominal aorta. Also, the presence of a hemodynamically notable renal artery stenosis and antibodies to C pneumoniae (IgG and IgA) and CMV (IgG and IgM) was determined, and all classic risk factors were recorded. RESULTS: Atherosclerotic lesions were documented in 67 patients (70%), and in 49 patients (51%) such lesions were present at the level of the renal artery. In the univariate analysis, significant associations between IgG (odds ratio, 3.8; 95% confidence interval, 1.2-11.7; P =.02) as well as IgA (odds ratio, 2.6; 95% confidence interval, 1.1-6.7; P =.03) antibodies to C pneumoniae and the presence of atherosclerosis were found for both the aorta and the renal arteries. Seroprevalence (IgG) to C pneumoniae in the 23 patients with a hemodynamically notable renal artery stenosis was 100% and differed (P =.01) from those without a notable renal artery stenosis (78%). In the multivariate analysis, IgG seropositivity to C pneumoniae was significantly associated with atherosclerosis (odds ratio, 6.0; 95% confidence interval, 1.33-27.5; P =.02), and age. There was no association between CMV seropositivity and atherosclerosis. CONCLUSION: The presence of antibodies to C pneumoniae was significantly associated with atherosclerosis and renovascular disease in hypertensive patients in whom a renal artery stenosis was strongly suspected.     

Chlamydia pneumoniae infection is associated with coronary artery disease but not implicated in inducing plaque instability

BACKGROUND: Many authors have shown an association between Chlamydia pneumoniae (C. pneumoniae) infection and coronary artery disease. However, whether C. pneumoniae infection plays an important role in triggering an acute coronary event remains to be elucidated. METHODS: Sixty-four consecutive patients with unstable angina (group A), 56 consecutive patients with stable exertional angina (group B) and 74 control subjects (group C) were studied. The IgM, IgG and IgA anti-C. pneumoniae titers were assessed (microimmunofluorescence test Labsystem), values > or =1:16, > or =1:32 and > or =1:16 being respectively considered positive. RESULTS: IgM antibodies were found in 10.9% of group A and 12.5% of group B patients, whereas no subject of group C showed IgM titers (A vs. B, p=ns; C vs. A and B, p<0.05). Positive IgG titers were found in 76.6%, 82% and 44.6% in groups A, B and C, respectively (A vs. B, p=ns; C vs. A and B, p<0.05). Positive IgA titers were found in 62.5%, 61% and 31.1% in groups A, B and C, respectively (A vs. B, p=ns; C vs. A and B, p<0.05). Acute infection was observed in 10.9% and 12.5% of patients in groups A and B, respectively (p=ns); reinfection in 17% and 11%; no patient of the control group had signs of acute infection or reinfection. Chronic infection was observed in 34.4% and 37.5% in group A and B, respectively (p=ns). CONCLUSION: C. pneumoniae infection is associated with coronary artery disease, but no difference in serology is present between unstable and stable angina. Therefore, it does not seem implicated in triggering an acute coronary event.     

Lack of association between seropositivity to Chlamydia pneumoniae and carotid atherosclerosis.

Since the Chlamydia pneumoniae (C. pneumoniae)-specific antibody was shown to be associated with acute myocardial infarction and chronic coronary heart disease, the role of C. pneumoniae in the etiology of cardiovascular disease has been studied by a number of groups. We investigated the association between the C. pneumoniae-specific antibody, measured by microimmunofluorescence, risk factors for cardiovascular disease, and atherosclerosis in a randomly selected urban population. Overall, immunoglobulin-G (IgG) seroprevalence to C. pneumoniae in this sample of 1,034 subjects was 58%, whereas IgA seroprevalence was 32%. There was a decline in seropositivity with age for IgG but not IgA. Men were more likely than women to be IgG (66% vs 51%, chi-square p = 0.001) and IgA seropositive (36% vs 28%, chi-square p = 0.005). Current smokers had higher IgA seropositivity than nonsmokers (43% vs 30%). Those patients with a family history of cerebrovascular disease were more likely to have IgG antibody than those without (75% vs 57%, chi-square p= 0.007). Neither IgG nor IgA seropositivity was associated with the standard risk factors of hypertension, hyperlipidemia, or family history of ischemic heart disease, nor was seropositivity associated with carotid intima medial thickening (IMT) or atherosclerotic plaque as measured by carotid B-mode ultrasound. There was no difference between those participants who were IgG or IgA seropositive and seronegative in measurements of mean IMT, prevalence of abnormal IMT, and percentage with atherosclerotic plaque. In conclusion, although C. pneumoniae was associated with several risk factors for cardiovascular disease in a large cross-sectional population, we found no independent association between seroprevalence to C. pneumoniae and carotid atherosclerosis as measured by carotid IMT.     

Antibodies to Chlamydia pneumoniae and haemostatic factors in acute coronary syndrome without ST segment elevation

BACKGROUND: Various chronic infections, including Chlamydia pneumoniae (C. pneumoniae), are regarded as one of the possible factors which initiates, progresses and exacerbates atherosclerotic process. The relationship between C. pneumoniae infection and haemostatic factors which also may promote atherosclerosis, has not yet been established. AIM: To assess the relationship between C. pneumoniae-specific IgA and IgG serum antibodies and haemostatic factors in patients with acute coronary syndrome (ACS). METHODS: The study group consisted of 31 patients (17 males, mean age 62 years, and 14 females, mean age 60.6 years) with ACS and without ST segment elevation in whom antibodies to C. pneumoniae and such haemostatic factors as von Willebrand factor (vWF), thrombomodulin (TM), tissue plasmin activator (tPA), tPA inhibitor (PAI-1) and fibrinogen were measured. RESULTS: The proportion of patients with C. pneumoniae seropositivity was 35.4% in our study which is lower than that reported in literature. No significant relationship between vWF, TM, tPA and PAI-1 levels, and C. pneumoniae infection was found whereas a significant (p=0.05) relationship between C. pneumoniae-specific IgG antibodies and fibrinogen level was detected. CONCLUSIONS: Excluding fibrinogen, the presence of antibodies to C. pneumoniae is not associated with increased levels of haemostatic factors in patients with ACS without ST segment elevation.     

Prevalence of Chlamydia pneumoniae in the atherosclerotic plaque of patients with unstable angina and its relation with serology

BACKGROUND: Chlamydia pneumoniae has been associated with coronary artery disease by both seroepidemiological studies, and by direct detection of the micro-organism in atherosclerotic lesions. This bacteria could play a potential role in the development of acute coronary events. We examined coronary arteries from patients with unstable angina in order to verify an endovascular presence of C. pneumoniae, and to determine if there is any relationship between serology of acute infection by this pathogen and its presence inside the atherosclerotic plaque of these patients. METHODS: We analysed a total of 76 atherosclerotic plaques obtained from 45 patients who underwent coronary artery bypass surgery. In all patients unstable angina was present within the prior 3 weeks. The presence of C. pneumoniae in the plaque was determined by nested polymerase chain reaction (PCR). Antichlamydial immunoglobulin G (IgG), A (IgA) and M (IgM) was examined by microimmunofluorescence and compared to the PCR result. FINDINGS: DNA of C. pneumoniae was detected in 57 (75%) of 76 atherosclerotic lesions. In most cases (74/76: 97%) a positive IgA, IgM or IgG result was seen. Seven (12%) and 54 (94%) of the 57 PCR positive plaques came from patients with a positive IgM and IgA result, respectively. There was no statistical significant difference between PCR positive and PCR negative plaques in patients with a positive or negative serological result. Clinical characteristics were similarly distributed in patients with and without infected lesions. INTERPRETATION: C. pneumoniae organisms are frequently found in the atherosclerotic lesions of patients undergoing coronary surgery for unstable angina. Neither serological results of acute or recent infection by C. pneumoniae nor clinical characteristics are useful in predicting the individual risk of harbouring C. pneumoniae in the coronary lesions of patients with unstable angina.     

Chlamydia pneumoniae seropositivity and early carotid atherosclerosis in a suburban Japanese population

To evaluate the association between Chlamydia pneumoniae (C. pneumoniae) infection and carotid atherosclerosis (CA), we investigated CA assessed by carotid B-mode ultrasound and known or suspected atherosclerotic risk factors including C. pneumoniae IgG and IgA antibodies in 2410 residents (mean age 54.5+/-13.6 years, 697 men) of a suburban Japanese town. CA was found in 30.1% of men and in 14.0% of women, IgG in 59.4% and in 51.4%, and IgA in 36.9% and in 32.4%, respectively. In univariate analysis, most conventional atherosclerotic risk factors and IgA antibody were significantly associated with CA in both sexes, but not IgG. In multivariate logistic regression analysis, independent risk factors for CA were confirmed with age and triglycerides (TG) in men and age, systolic blood pressure, pack-years of smoking, and low-density lipoprotein cholesterol (LDL-C) in women, but not IgG and IgA in either sex. These results do not support C. pneumoniae infection as an important risk factor for CA in this Japanese population.     

Chlamydial antibodies in an elderly Finnish population.

The characteristic feature of Chlamydia is its tendency to cause chronic infections. It has been hypothesized that prior exposure to C. pneumoniae may lead to chronic infection and the development of associated chronic cardiopulmonary disease. Few studies have so far addressed the occurrence of chlamydial antibodies in an elderly, unselected population. This information is important for the development of possible treatment strategies. Chlamydial antibodies were analysed from 1179 serum samples obtained from 481 men and 698 women, aged 64 y and over, who participated in an epidemiological survey carried out in a Finnish rural district. Specific IgG and IgA antibodies were measured by the microimmunofluorescence (micro-IF) test. The criterion for seropositivity was defined as a titre of > or =32 for both IgG and IgA, independently of each other. C. pneumoniae IgG antibodies occurred in 91% of the men and 75% of the women. The respective figures for C. pneumoniae IgA antibodies were 57% and 28%. The geometric mean titres (GMT) rose with increasing age and were higher in men than in women. The prevalences of C. trachomatis IgG antibodies were 13% in men and 18% in women, and for IgA antibodies, 2% and 1%, respectively. C. psittaci antibodies were rare. Only 3% of the men and women were IgG seropositive, whereas the respective figures for IgA seropositivity were 0.4% and 0.1%. C. pneumoniae antibodies indicative of recurrent or chronic infection were common in the elderly. The geometric mean titres correlated positively with age and were higher in men than in women. Other chlamydial antibodies occurred in low titres.     

The Study of Chlamydia Pneumoniae DNA in the Peripheral Blood Mononuclear Cell of Coronary Heart Disease

Cardiovascular disease is the leading cause of death in developed countries. The cause is multifactori- al. A substantial proportion of patients with coronary artery disease do not have traditional risk factors. Therefore, scientific attention has recently focused on investigating hypothetical additional risk factors and on achieving a deeper understanding of the development of atherosclerosis . Infectious diseases may play a role in these cases , or they may intensity the effect of other risk…     

Lack of association between prior infection with Chlamydia pneumoniae and acute or chronic coronary artery disease

BACKGROUND: Higher than normal serologic titers and the detection of bacteria within atheroma have suggested an association between Chlamydia pneumoniae (C. pneumoniae) infection and coronary heart disease (CHD), but the relationship has not been well established. HYPOTHESIS: The study was designed to establish a lack of relationship between chronic C. pneumoniae infection and CHD. METHODS: Chlamydia-specific IgG-antibody was assayed using an indirect immunofluorescence test in the serum of 159 patients with severe arterial disease and 203 patients with a heart valve prostheses and no demonstrable CHD. Fatal and nonfatal vascular events and systemic thromboembolism were recorded over a 2-year period. RESULTS: In the arterial group 107 patients (67.3%) and in the valvular group 120/203 (59.1%) were positive for C. pneumoniae antibody. The number of patients with fatal or nonfatal vascular events (double end point) in the arterial and valvular groups was 23 and 2, respectively (p < .0001). Triple end points (fatal plus nonfatal vascular events plus thromboembolism) were also more frequent in the arterial group (p < 0.002). The prevalence of chlamydia antibody positivity was the same in the arterial and valvular groups, and the occurrence of clinical events was also the same for chlamydia-positive (227 patients) as for chlamydia-negative (135 patients). After adjustment for confounding variables, only arterial disease was a predictive factor for double (OR 17.0; 95% CI 3.94-73.3) or triple (OR 3.12; 95% CI 1.56-6.25) end points. CONCLUSION: We find C. pneumoniae chronic infection not to be an independent risk factor for acute or chronic arterial disease.     

Association of seropositivity for antibody to Chlamydia-specific lipopolysaccharide and coronary artery disease in Japanese men

Recent studies suggest an association between Chlamydia pneumoniae infection and coronary artery disease (CAD). To examine this relationship in Japanese men, serum IgA and IgG antibodies to Chlamydia-specific lipopolysaccharide were measured by enzyme-linked immunosorbent assay in 507 patients with CAD and 200 age-matched controls. CAD patients were divided into (1) 269 patients with myocardial infarction (MI) and (2) 238 patients with chronic coronary heart disease (CCHD). Compared with the control group, the CAD group did not differ in the prevalences of both antibodies (IgA: 23.7 vs 18.0%, p=0.10; IgG: 52.7 vs 51.0%, p=0.6). The index of IgG antibody was not significantly different between CAD and control groups (median 1.19 vs 1.18, p=0.3), whereas the index of IgA antibody was significantly higher in CAD than control group (median 0.60 vs 0.46, p<0.0001). Compared with the control group, the MI group had a significantly higher prevalence of IgA antibody (28.6 vs 18.0%, p=0.007); however, there was no difference in the prevalence of IgG antibody (58.0 vs 51.0%, p=0.13). The CCHD group did not differ in the prevalences of both antibodies (IgA: 18.1 vs 18.0%, p=0.9; IgG: 45.6 vs 51.0%, p=0.2). After the adjustment for coronary risk factors, odds ratios (ORs) of seropositive antibodies for CAD were 1.59 [95% confidence interval (CI): 0.88-2.87, p=0.12] for IgA seropositivity and 0.92 (95%CI: 0.58-1.47, p=0.7) for IgG seropositivity in all cases. In the MI and control groups, ORs of seropositive antibodies for MI were 2.67 (95%CI: 1.32-5.38, p=0.007) for IgA seropositivity, and 1.36 (95%CI: 0.79-2.36, p=0.2) for IgG seropositivity. This study discovered that IgA antibody to Chlamydia was significantly associated with CAD, especially with MI, in Japanese Men and the findings suggest that chronic infection of Chlamydia may be linked to the pathogenesis of MI.