1
|
Villegas E, Sorlózano A, Gutiérrez J. Serological diagnosis of Chlamydia pneumoniae infection: limitations and perspectives. J Med Microbiol 2010; 59:1267-1274. [PMID: 20724512 DOI: 10.1099/jmm.0.020362-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Chlamydia pneumoniae is an obligate intracellular human pathogen responsible for a wide range of acute and chronic human diseases, including pneumonia and other respiratory diseases. Serological methods for the diagnosis of C. pneumoniae infection vary widely, and several authors have reported significant inter- and intra-laboratory variability in diagnostic methods and criteria. Over the past 10 years, numerous studies have focused on the identification of specific antigens for application in serodiagnosis, including the diagnosis of persistent infections. The use of proteomics may enable the development of serological diagnosis kits that offer reliable sensitivity and specificity and might even differentiate between the various stages of infection with this pathogen.
Collapse
Affiliation(s)
- Enrique Villegas
- Departamento de Microbiología, Universidad de Granada, Granada, Spain
| | - Antonio Sorlózano
- Departamento de Microbiología, Universidad de Granada, Granada, Spain
| | - José Gutiérrez
- Laboratorio de Microbiología, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Departamento de Microbiología, Universidad de Granada, Granada, Spain
| |
Collapse
|
2
|
Kloppenburg GTL, de Graaf R, Grauls GELM, Bruggeman CA, Stassen FR. Chlamydia pneumoniae aggravates vein graft intimal hyperplasia in a rat model. BMC Microbiol 2007; 7:111. [PMID: 18062811 PMCID: PMC2222630 DOI: 10.1186/1471-2180-7-111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Accepted: 12/06/2007] [Indexed: 11/29/2022] Open
Abstract
Background Along with angioplasty, autologus vein grafts are commonly used for artery bypass grafting in patients with advanced arterial stenosis and drug-resistant angina pectoris. Although initially a successful procedure, long-term functionality is limited due to proliferation and migration of smooth muscle cells. Like in atherosclerosis, common chronic infections caused by viruses and bacteria may contribute to this process of vein graft failure. Here we investigated the possible role of Chlamydia pneumoniae (Cpn) in the pathogenesis of venous graft failure in an experimental animal model. In 2 groups (n = 10 rats/group), an epigastric vein-to-common femoral artery interposition graft was placed. Immediately thereafter, rats were infected with Cpn (5*108 IFU) or injected with control solutions. Rats were sacrificed three weeks after surgery and the grafts were harvested for morphometrical and immunohistochemical analysis. Results Cpn administration immediately after vein grafting resulted in a significant increase in medial cross-sectional area, wall thickness and total wall area. There were no significant differences in T-cell or macrophage influx. Likewise, although positive immunostaining for both HSP60 and CRP could be detected, no differences were found between groups. Based on the observation that the number of cells/μm2 was also not altered, we conclude that Cpn infection stimulates smooth muscle cell proliferation by hereunto unknown molecular mechanisms, resulting in a significant increase in intimal hyperplasia. Conclusion In conclusion, in a well defined animal model we present here for the first time evidence for a role of Chlamydia pneumoniae in the process of venous graft failure.
Collapse
Affiliation(s)
- Geoffrey T L Kloppenburg
- Cardiovascular Research Institute Maastricht, Department of Medical Microbiology, Academic Hospital Maastricht/Maastricht University, Maastricht, MD Maastricht, The Netherlands.
| | | | | | | | | |
Collapse
|
3
|
Kälvegren H, Andersson J, Grenegård M, Bengtsson T. Platelet activation triggered by Chlamydia pneumoniae is antagonized by 12-lipoxygenase inhibitors but not cyclooxygenase inhibitors. Eur J Pharmacol 2007; 566:20-7. [PMID: 17459368 DOI: 10.1016/j.ejphar.2007.03.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Revised: 03/02/2007] [Accepted: 03/06/2007] [Indexed: 10/23/2022]
Abstract
Chlamydia pneumoniae is a respiratory pathogen that has been linked to cardiovascular disease. We have recently shown that C. pneumoniae activates platelets, leading to oxidation of low-density lipoproteins. The aim of the present study was to evaluate the inhibitory effects of different pharmacological agents on platelet aggregation and secretion induced by C. pneumoniae. Platelet interaction with C. pneumoniae was studied by analyzing platelet aggregation and ATP-secretion with Lumi-aggregometry. Platelet aggregation and ATP-secretion induced by C. pneumoniae was markedly inhibited by the NO-donor S-nitroso-N-acetyl-D,L-penicillamine (SNAP), an effect that was counteracted by the guanylyl cyclase inhibitor 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ). Pre-treatment of platelets with the 12-lipoxygenase (12-LOX) inhibitors cinnamyl-3,4-dihydroxy-alpha-cyanocinnamate (CDC) and 5,6,7-trikydroxyflavone (baicalein) completely blocked the activation, whereas the cyclooxygenase (COX) inhibitors 2-acetyloxybenzoic acid (aspirin) and (8E)-8-[hydroxy-(pyridin-2-ylamino)methylidene]-9-methyl-10,10-dioxo-10$l;(6)thia-9-azabicyclo[4.4.0]deca-1,3,5-trien-7-one (piroxicam) had no inhibitory effects. Opposite to C. pneumoniae-induced activation, platelets stimulated by collagen were inhibited by the COX-inhibitors but were unaffected by the 12-LOX-inhibitors. The platelet activating factor (PAF) antagonist Ginkgolide B blocked the C. pneumoniae-induced platelet activation, whereas the responses to collagen were unaffected. Furthermore, the P2Y1 and P2Y12 purinergic receptor antagonists 2'-deoxy-N6-methyladenosine 3',5'-bisphosphate (MRS2179) and N(6)-(2-methyl-thioethyl)-2-(3,3,3-trifluoropropylthio)-beta,gamma-dichloromethylene-ATP (cangrelor) inhibited the aggregation and secretion caused by C. pneumoniae. It is well-known that the efficacy of COX inhibitors in the prevention and treatment of cardiovascular disease varies between different patients, and that patients with low responses to aspirin have a higher risk to encounter cardiovascular events. The findings in this study showing that platelets stimulated by C. pneumoniae are unaffected by COX inhibitors but sensitive to 12-LOX inhibitors, may thus be of importance in future management of atherosclerosis and thrombosis.
Collapse
Affiliation(s)
- Hanna Kälvegren
- Division of Pharmacology, Department of Medicine and Care, Cardiovascular Inflammation Research Centre, Faculty of Health Sciences, Linköping University, SE-581 85 Linköping, Sweden.
| | | | | | | |
Collapse
|
4
|
Kaperonis EA, Liapis CD, Kakisis JD, Dimitroulis D, Papavassiliou VG, Perrea D, Kostakis AG. Inflammation and Chlamydia pneumoniae Infection Correlate with the Severity of Peripheral Arterial Disease. Eur J Vasc Endovasc Surg 2006; 31:509-15. [PMID: 16427340 DOI: 10.1016/j.ejvs.2005.11.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2005] [Accepted: 11/24/2005] [Indexed: 11/16/2022]
Abstract
BACKGROUND Our aim was to investigate the association of inflammation and Chlamydia pneumoniae infection with the presence and severity of peripheral arterial disease. METHODS Twenty-eight patients whose initial claudication distance (ICD) in the traditional constant-load treadmill test was <200 m, underwent femoral endarterectomy as part of their interventional treatment (group A). Group B consisted of 23 patients whose ICD was >200 m and were put on medication and a daily exercise program. The control group consisted of 30 non-vascular patients of the Ophthalmology Department (group C). We measured the levels of C-reactive protein, fibrinogen, vascular cell adhesion molecule-1 and tumor necrosis factor-alpha, and the titers of IgA and IgG antibodies against C. pneumoniae in the serum of all the patients. Finally, the atheromas and vein segments of group A patients, were immunohistochemically (IHC) examined for the presence of C. pneumoniae. RESULTS Peripheral arterial disease (PAD) patients, had significantly higher CRP (p=0.026) and anti-Cp IgA levels (p=0.001) when compared to control subjects, after a multiple linear regression analysis. The odds ratio for the prevalence of femoral atherosclerosis was 3.16 for IgA seropositive patients (CI 1.15-8.67). When comparing group A and group B patients, CRP (p=0.003) and IgA (p=0.011), were significantly correlated with severe PAD. Group A patients with positive immunohistochemical examination of the plaque, had higher anti-Cp IgA levels (p=0.023) and TNF-alpha values (p=0.031), compared to the IHC negative patients. C. pneumoniae was detected in 50% of the femoral atheromas, but in only 3.6% of the veins. CONCLUSION This study supports the hypothesis that inflammation (CRP) and chronic C. pneumoniae infection (IgA seropositivity), have an important role in lower limb atherosclerosis and correlate with the severity of the disease.
Collapse
Affiliation(s)
- E A Kaperonis
- 2nd Department of Propedeutic Surgery, Laikon Hospital, Athens University Medical School, Athens, Greece.
| | | | | | | | | | | | | |
Collapse
|
5
|
Gutiérrez J, Linares J, Camacho A, Palanca M, Maroto C, Ros E, Luna JD, José Soto M, Sorlózano A. Descripción de inmunógenos de Chlamydia pneumoniae reconocidos por el suero de sujetos con enfermedad arterial periférica. Med Clin (Barc) 2006; 126:721-7. [PMID: 16759586 DOI: 10.1157/13088945] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND OBJECTIVE The relationship between antibodies to C. pneumoniae and presence of the bacteria was studied in individuals with peripheral arterial disease. PATIENTS AND METHOD An observational analytical, case-control study was performed in 118 patients (68 cases, 50 controls) to investigate immunoglobulin (Ig) G and A against C. pneumoniae in serum, using Western-blot (commercial and no commercial methods), ELISA and MIF; DNA of the bacteria in vascular tissue biopsy specimens was studied by polymerase chain reaction. RESULTS Using commercial Western-blot, significant presence of IgG anti-39 kDa and anti-54 kDa was found in cases and was related to MIF results and C. pneumoniae DNA findings; IgA anti-LPS, anti-92 kDa and anti-Hsp60 kDa were also found and related to DNA presence. Using no commercial Western-blot, significant presence of 128.8 and 9.2 kDa bands for IgG was detected in cases and associated with DNA presence; 70.8, 58.9, 47.9, 47.5, 18.4, 12.1, 10.6, 8.1, and 7.6 kDa bands for IgG were found in cases; and DNA was present when 54.6 and 1.1 kDa bands for IgG and 79.4, 50.1, and 18.4 kDa bands for IgA were also detected. CONCLUSIONS Using Western-blot, a greater serologic response was found against certain proteins of the bacteria in individuals with peripheral arterial disease. This may reflect an initial stage with presence of DNA and specific IgG. Subsequently, even in absence of the bacteria, an immunomediated disease may develop with presence of IgA and IgG.
Collapse
Affiliation(s)
- José Gutiérrez
- Departamento de Microbiología, Universidad de Granada, España.
| | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Fernández F, Gutiérrez J, Linares J, Rojas A, Sorlózano A. A positive association of peripheral arterial occlusive disease (PAD) andChlamydophila (Clamydia) pneumoniae. J Basic Microbiol 2005; 45:294-300. [PMID: 16028201 DOI: 10.1002/jobm.200410501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The relationship between Chlamydophila pneumoniae (Cp) infection and peripheral arterial occlusive disease (PAD) was studied by analyzing clinical samples from 95 patients with PAD and 100 controls. The following investigations were conducted: IgG and IgA against lipopolysaccharide (LPS) and against purified Cp-specific antigens from elementary bodies (EB) with ELISA; anti-EB IgG, with MIF; Cp DNA in arterial biopsy and peripheral blood mononuclear cells with heminested PCR; LPS with ELISA; and bacteria culture in HEp-2 cells from arterial biopsy. A significantly higher ratio of anti-EB IgG was detected in patients. There were no significant differences in anti-LPS IgG, anti-LPS IgA and anti-EB IgA between cases and controls. Cp DNA findings in the vascular wall biopsy showed significant differences between cases and controls. We obtained results that significantly involve Cp infection with PAD through the detection of anti-EB IgG from serum and bacterial DNA from arterial biopsy.
Collapse
Affiliation(s)
- F Fernández
- Department of Microbiology, University Hospital San Cecilio, University of Granada, Granada, Spain
| | | | | | | | | |
Collapse
|
7
|
Krayenbuehl PA, Wiesli P, Maly FE, Vetter W, Schulthess G. Progression of peripheral arterial occlusive disease is associated with Chlamydia pneumoniae seropositivity and can be inhibited by antibiotic treatment. Atherosclerosis 2005; 179:103-10. [PMID: 15721015 DOI: 10.1016/j.atherosclerosis.2004.08.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2004] [Revised: 07/21/2004] [Accepted: 08/30/2004] [Indexed: 10/26/2022]
Abstract
A possible influence of Chlamydia pneumoniae seropositivity on the clinical course of peripheral arterial occlusive disease (PAOD) has not been investigated previously. Though roxithromycin therapy was found to inhibit progression of PAOD, the nature of this effect (antibiotic or anti-inflammatory) has remained elusive. The course of PAOD was prospectively assessed in elderly men during 4 years, comparing 51 C. pneumoniae seropositive (IgG>/=1:128) with 46 seronegative patients (IgG<1:64 and IgA<1:32). Twenty of the seropositive patients were treated with roxithromycin (400 mg daily) for 4 weeks. Limitation of the walking distance to 200 m or less was observed in 55% of the seropositive untreated patients as compared to 30% of both, seronegative and macrolide-treated patients. The number of invasive revascularizations per patient was 1.7 in the seropositive untreated group as compared to 0.5 in the seronegative and the macrolide-treated group. Considering possible confounding variables, such as classical vascular risk factors, ordinal regression analyses showed a significant association of C. pneumoniae seropositivity with limitation of the walking distance (p=0.027) and need for invasive revascularization (p=0.037). The effect of macrolide treatment on these outcome measures was marked (p<0.001 and p=0.040, respectively) during 2.7 years but decreased in the second part of the observation period. This study provides good evidence that C. pneumoniae are involved in the progression of PAOD and that antibiotic treatment directed against C. pneumoniae is effective in inhibiting this process.
Collapse
|
8
|
Karppinen J, Kurunlahti M, Taimela S, Haapea M, Vanharanta H, Tervonen O. Determinants of lumbar artery occlusion among patients with sciatica: a three-year follow-up with magnetic resonance angiography. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2005; 14:664-70. [PMID: 15723216 PMCID: PMC3489218 DOI: 10.1007/s00586-004-0860-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2004] [Revised: 09/30/2004] [Accepted: 11/22/2004] [Indexed: 11/26/2022]
Abstract
We showed previously that chronic Chlamydia pneumoniae infection increases the risk of lumbar artery occlusion. We did not evaluate, however, the effect of other risk factors for cardiovascular diseases in combination with this chronic infection. The purpose of this study was to investigate the combined effect of chronic C. pneumoniae infection and other known determinants of artery occlusion in a population of sciatica patients. Two-dimensional time-of-flight magnetic resonance angiography (MRA) was used to evaluate lumbar arteries at baseline and three years. The arteries on both sides (L1-L4) were evaluated visually and scored as normal, narrowed or occluded. Logistic regression analysis was performed separately for baseline total arterial stenosis and each L1-L4 segmental artery pair, and for incident new stenosis during the follow-up period. The determinants analyzed included age, body mass index (BMI, kg/m(2)), education, gender, and smoking, in addition to presence of chronic C. pneumoniae infection. MRA was obtained at baseline for 147 patients and at 3 years for 134 patients. Sixty-four (47.8%) of 134 patients had new arterial stenosis. Total incidence of new arterial stenosis was distributed quite evenly between the individual segmental levels, varying from 12.7 to 18.6%. BMI was the only predictor of new arterial stenosis (odds ratio (OR) 1.13). A reasonable logistic model could be established only for baseline L4 and total arterial scores. At L4, education was a protective factor (OR 0.07), whereas age (OR for the oldest age group 6.7) and BMI (OR 1.17) were associated with increased risk of occlusion. For total arterial score, chronic C. pneumoniae infection was an independent determinant of arterial occlusion, increasing the risk to almost eightfold. Additionally, BMI (OR 1.16), and age (for the oldest age group OR 11.4) were significant determinants for stenosis. Smoking was not statistically significant. As chronic C. pneumoniae infection was an independent determinant of lumbar artery occlusion, treatments of this chronic infection may have an impact on lumbar diseases. The importance of BMI for new arterial stenosis suggests that weight reduction may also have a beneficial effect in lumbar artery disease.
Collapse
Affiliation(s)
- Jaro Karppinen
- Department of Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland.
| | | | | | | | | | | |
Collapse
|
9
|
McDonald SP, Hoy WE. Interfaces between cardiovascular and kidney disease among Aboriginal Australians. Adv Chronic Kidney Dis 2005; 12:39-48. [PMID: 15719332 DOI: 10.1053/j.ackd.2004.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Rates of kidney disease among several indigenous groups have been shown to be substantially higher than corresponding non-indigenous groups. This excess has been clearly shown among Aboriginal Australians with respect to both end-stage kidney disease and early kidney disease. Rates of cardiovascular disease among Aboriginal Australians are also very high, as are rates of diabetes, smoking, and possibly overweight and obesity. These factors have been traditionally linked with cardiovascular and renal disease as part of a broader "metabolic syndrome." However, the links and interfaces between cardiovascular and kidney disease in this environment extend beyond these "traditional" factors. The factors associated with atherosclerosis have expanded in recent years to include markers of inflammation, some infection, antioxidants, and other "non-traditional" risk factors. Given the high rates of acute infection and poor living conditions endured by many indigenous people, one might expect these "non-traditional" risk factors to be highly prevalent. In this review, we explore the relationships between markers of inflammation, some serological markers of infection, and other selected markers and both cardiovascular and renal disease. In doing so, we demonstrate links between kidney and cardiovascular disease at a number of levels, beyond the "traditional" cardiovascular/renal risk factors. Many of these factors are beyond the control of the individual or even community; addressing these issues a broader focus and biopsychosocial model.
Collapse
Affiliation(s)
- Stephen P McDonald
- ANZDATA Registry, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia.
| | | |
Collapse
|
10
|
Sodeck G, Domanovits H, Khanakah G, Schillinger M, Thalmann M, Bayegan K, Schoder M, Grabenwoeger M, Hoelzenbein T, Boehmig G, Laggner AN, Stanek G. The Role of Chlamydia Pneumoniae in Human Aortic Disease—A Hypothesis Revisited. Eur J Vasc Endovasc Surg 2004; 28:547-52. [PMID: 15465378 DOI: 10.1016/j.ejvs.2004.07.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND The role of Chlamydia pneumoniae in the pathogenesis of aortic aneurysm is controversial. We investigated the presence of C. pneumoniae in tissue samples excised from patients and controls. METHODS Aortic wall specimens were obtained from 17 patients with acute Stanford type A aortic dissection, 25 patients with thoracic aortic aneurysms (TAA) and 23 patients with abdominal aortic aneurysms (AAA). Eighty-three tissue samples of 73 control patients free of aortic disease were obtained either at surgery or autopsy. The presence of Chlamydia subspecies DNA (sequences specific for all known Chlamydiaceae) and DNA of C. pneumoniae, C. trachomatis and C. psittaci were assessed by a validated highly sensitive and specific real time polymerase chain reaction (PCR) analysis. Atherosclerotic risk factors were assessed in all patients. RESULTS We failed to detect C. pneumoniae and C. psittaci-DNA in any of the 148 vessel specimens. C. trachomatis-DNA was detected in 1/65 patients and in none of 83 controls (P=0.43). Chlamydia subspecies DNA was found in samples of eight cases and in one control (P=0.01), however, no significant differences were found between the subgroups aortic dissection (P=0.09), TAA (P=0.99) and AAA (P=0.15) and respective controls. CONCLUSIONS C. pneumoniae does not play a clinically relevant role in acute and chronic aortic disease. The impact of other organisms of the family Chlamydiaceae needs further evaluation.
Collapse
Affiliation(s)
- G Sodeck
- Department of Emergency Medicine, Medical University of Vienna, General Hospital Vienna, Austria, Europe
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Gutiérrez J, Linares J, Fernández F, Ros E, Luna JDD, Mendoza J, Soto MJ, López C, Maroto C. [Relationship between the peripheral arterial occlusive disease and the infection by Chlamydophila pneumoniae]. Med Clin (Barc) 2004; 123:561-6. [PMID: 15535936 DOI: 10.1016/s0025-7753(04)74598-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE The relationship between peripheral arterial occlusive disease (PAOD) and Chlamydophila pneumoniae infection was studied by analyzing clinical samples from 95 patients with PAOD (cases) and 100 controls. PATIENTS AND METHOD The following investigations were conducted: IgG and IgA against lipopolysaccharide (LPS) and against purified C. pneumoniae-specific antigens from elementary bodies (EB) with ELISA; anti-EB IgG, with MIF; C. pneumoniae DNA in arterial biopsy and peripheral blood leukocyte cells (PBLCs) with heminested PCR; LPS with ELISA; and bacteria culture in HEp-2 cells from arterial biopsy. RESULTS The percentage of positive results in cases and controls groups for anti-LPS IgG was: 21% and 14%, respectively, with no differences; nor were there any differences with IgA (22 and 21%, respectively). However, differences were seen in the anti-EB IgG between cases (74% and 72%, for ELISA and MIF, respectively) and controls (31% and 34%). There were no differences in anti-EB IgA. Bacterial DNA was detected in 67% of atheromatous plaques (cases) vs. 12% of pudendal arteries (controls) (p = 0.0001). No C. pneumoniae DNA and LPS was detected in PBLCs and biopsic samples, respectively; and no C. pneumoniae strain could be recovered by cell culture from cases. CONCLUSIONS On the basis of our results, PAOD is significantly associated with C. pneumoniae infection through the detection of anti-EB IgG from serum and bacterial DNA from arterial biopsy.
Collapse
Affiliation(s)
- José Gutiérrez
- Departamento de Microbiología, Universidad de Granada, Granada, Spain.
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Linares-Palomino JP, Gutiérrez J, Lopez-Espada C, de Dios Luna J, Ros E, Maroto C. Genomic, serologic, and clinical case-control study of Chlamydia pneumoniae and peripheral artery occlusive disease. J Vasc Surg 2004; 40:359-66. [PMID: 15297834 DOI: 10.1016/j.jvs.2004.04.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Chlamydia pneumoniae has been related to atherosclerotic disease in both seroepidemiologic and genomic studies. We performed a case-control study to determine seropositivity and DNA detection in arteries of patients with peripheral artery occlusive disease and of healthy subjects. METHODS The study included 64 patients with peripheral artery occlusive disease, and 50 control subjects who underwent varicose vein surgery, matched to the patient group for age, sex, and tobacco use. The fibrinogen level in all study subjects was measured as a marker of inflammation. Blood samples were taken from all subjects for determination of immunoglobulin (Ig) G elementary bodies (EB) against C pneumoniae with microimmunofluorescence (MIF) and enzyme-linked immunosorbent assay (ELISA), and of IgA EB with ELISA. The cutoff titers were 1:32 for MIF and 1.1 for ELISA. Biopsy specimens of arterial atheromatous plaque were obtained from patients, and of pudendal artery and saphenous vein from control subjects, and were studied with hemi-nested polymerase chain reaction. RESULTS There were no differences in fibrinogen level between patients and controls. The prevalence of IgG anti-EB with MIF was 78% in patients and 24% in control subjects (P =.0001; odds ratio [OR], 11.3; 95% confidence interval [CI], 4.7-27.2). Prevalence of IgG anti-EB with ELISA was 75% in patients and 16% in control subjects (P =.0001; OR, 15.7; 95% CI, 6.1-40). There were no differences in IgA anti-EB titers. Bacterial DNA was detected in 67% of atheromatous plaques versus 12% of pudendal arteries (P =.0001) and 4% of saphenous veins. A weak correlation was found between seropositivity and the presence of intravascular DNA. CONCLUSIONS Our results support the hypothesis that C pneumoniae is related to the pathogenesis of atherosclerotic peripheral artery occlusive disease. CLINICAL RELEVANCE This study explored the infectious hypothesis in the context of the pathogenesis of atherosclerosis. This hypothesis has been supported by findings that certain infectious agents can cause or accelerate the course of diseases in which the possibility of a microbial cause was not previously proposed, as in the case of peptic ulcer and spongiform encephalopathy. The present study demonstrated the presence of Chlamydia pneumoniae and seropositivity in atheromatous plaques in patients with peripheral artery occlusive disease. These results contribute to a body of research that is opening up the possibility of treating atherosclerotic disease with antibiotic agents, and preventing it with immunization.
Collapse
|
13
|
Mygind T, Østergaard L, Birkelund S, Lindholt JS, Christiansen G. Evaluation of five DNA extraction methods for purification of DNA from atherosclerotic tissue and estimation of prevalence of Chlamydia pneumoniae in tissue from a Danish population undergoing vascular repair. BMC Microbiol 2003; 3:19. [PMID: 12952556 PMCID: PMC201026 DOI: 10.1186/1471-2180-3-19] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2003] [Accepted: 09/02/2003] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND To date PCR detection of Chlamydia pneumoniae DNA in atherosclerotic lesions from Danish patients has been unsuccessful. To establish whether non-detection was caused by a suboptimal DNA extraction method, we tested five different DNA extraction methods for purification of DNA from atherosclerotic tissue. RESULTS The five different DNA extraction methods were tested on homogenate of atherosclerotic tissue spiked with C. pneumoniae DNA or EB, on pure C. pneumoniae DNA samples and on whole C. pneumoniae EB. Recovery of DNA was measured with a C. pneumoniae-specific quantitative real-time PCR. A DNA extraction method based on DNA-binding to spin columns with a silica-gel membrane (DNeasy Tissue kit) showed the highest recovery rate for the tissue samples and pure DNA samples. However, an automated extraction method based on magnetic glass particles (MagNA Pure) performed best on intact EB and atherosclerotic tissue spiked with EB. The DNeasy Tissue kit and MagNA Pure methods and the highly sensitive real-time PCR were subsequently used on 78 atherosclerotic tissue samples from Danish patients undergoing vascular repair. None of the samples were positive for C. pneumoniae DNA. The atherosclerotic samples were tested for inhibition by spiking with two different, known amounts of C. pneumoniae DNA and no samples showed inhibition. CONCLUSION As a highly sensitive PCR method and an optimised DNA extraction method were used, non-detection in atherosclerotic tissue from the Danish population was probably not caused by use of inappropriate methods. However, more samples may need to be analysed per patient to be completely certain on this. Possible methodological and epidemiological reasons for non-detection of C. pneumoniae DNA in atherosclerotic tissue from the Danish population are discussed. Further testing of DNA extraction methods is needed as this study has shown considerable intra- and inter-method variation in DNA recovery.
Collapse
Affiliation(s)
- Tina Mygind
- Department of Medical Microbiology and Immunology, Wilhelm Meyers Allé, The Bartholin Building, University of Aarhus, DK-8000 Aarhus C, Denmark
| | - Lars Østergaard
- Research Unit Q, Department of Infectious Diseases, Skejby Hospital, University Hospital of Aarhus, Brendstrupgaardsvej, DK-8200 Aarhus N, Denmark
| | - Svend Birkelund
- Department of Medical Microbiology and Immunology, Wilhelm Meyers Allé, The Bartholin Building, University of Aarhus, DK-8000 Aarhus C, Denmark
| | - Jes S Lindholt
- Department of Vascular Surgery, Viborg Hospital, Viborg, Denmark
| | - Gunna Christiansen
- Department of Medical Microbiology and Immunology, Wilhelm Meyers Allé, The Bartholin Building, University of Aarhus, DK-8000 Aarhus C, Denmark
| |
Collapse
|
14
|
Karppinen J, Mikkonen P, Kurunlahti M, Tervonen O, Paldanius M, Vasari P, Saikku P, Vanharanta H. Chronic Chlamydia pneumoniae infection increases the risk of occlusion of lumbar segmental arteries of patients with sciatica: a 3-year follow-up study. Spine (Phila Pa 1976) 2003; 28:E284-9. [PMID: 12897506 DOI: 10.1097/01.brs.0000083229.42276.a0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A magnetic resonance imaging follow-up study of lumbar arteries among patients with sciatica with chronic Chlamydia pneumoniae infection. OBJECTIVE To determine whether chronic infection causes occlusion of lumbar arteries. SUMMARY OF BACKGROUND DATA C. pneumoniae infection is associated with coronary heart disease, and the infectious pathogen has also been detected in abdominal aortic aneurysms and in atherosclerotic plaques. No studies are available on the effect of this infectious agent on lumbar arteries. METHODS Chronic infection was defined as persistent high positive immunoglobulin G and/or immunoglobulin A antibodies and/or the presence of immune complexes. The lumbar arteries, evaluated with two-dimensional time-of-flight magnetic resonance angiography, were scored as normal, narrowed, or occluded. The differences in the segmental and whole lumbar spine (segments L1-L4) sum of arterial occlusion at baseline and at 3 years, and the incidence of new arterial stenosis were compared in patients with and without chronic infection using the Kolmogorov-Smirnov test. RESULTS Patients with chronic infection were more likely to be persistent smokers (P = 0.006), male (P = 0.04), and more obese (P = 0.02) compared to patients with normal antibody levels. They had significantly higher degree of arterial stenosis at L4 segment at baseline and at 3 years (P = 0.001 and 0.002, respectively), in the whole lumbar spine at baseline and at 3 years (P < 0.001 for both), and at L1 and L3 segments at 3 years (P = 0.013 for both). The incidence of new arterial stenosis was similar in both patient groups. Patients with chronic infection also had significantly higher grade of endplate degeneration at L4-L5 (P = 0.008). CONCLUSIONS The results of this study suggest that chronic C. pneumoniae infection may induce stenosis of lumbar arteries.
Collapse
Affiliation(s)
- Jaro Karppinen
- Department of Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland.
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
Chlamydia pneumoniae, a respiratory pathogen, has been suggested as a risk factor for cardiovascular disease. Epidemiologic data are very controversial. Histopathologic and microbiologic studies have established an association between atherosclerosis and presence of C. pneumoniae, consistently finding C. pneumoniae DNA and antigens in atherosclerotic arteries. C. pneumoniae has been cultured from atherosclerotic arteries in several centers. An etiologic role for C. pneumoniae in initiation, acceleration of atherosclerosis, and/or acute ischemia remains debatable. In vitro studies have shown that C. pneumoniae can induce foam cell formation, low-density lipoprotein oxidation, and proinflammatory and procoagulant cytokine expression. Animal models of de novo initiation or enhancement of atherosclerosis have been developed. Preliminary trials of secondary prevention of coronary artery disease complications by antimicrobial agents show modest results. Better diagnostic tools, more diverse animal models, and clinical trials of primary prevention are needed. Meanwhile, results of ongoing large clinical trials on secondary prevention are eagerly awaited, but may not be definitive.
Collapse
Affiliation(s)
- Maria Kolia
- Division of Infectious Disease, St. Michael's Hospital, 30 Bond Street, Room 4179V, Toronto, Ontario, M5W 1W8, Canada.
| | | |
Collapse
|