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Chung WS, Hsu WH, Lin CL, Kao CH. Mycoplasma pneumonia increases the risk of acute coronary syndrome: a nationwide population-based cohort study. QJM 2015; 108:697-703. [PMID: 25614614 DOI: 10.1093/qjmed/hcv015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Studies investigating the epidemiological relationship between Mycoplasma pneumonia (MP) and the subsequent development of acute coronary syndrome (ACS) are scant. We conducted a nationwide longitudinal cohort study in Taiwan to explore whether MP patients are at an increased risk of developing ACS. METHODS This study investigated the incidence and risk factors for ACS in 12 152 newly diagnosed MP patients from the Taiwan National Health Insurance Research Database between 2004 and 2011. The control group consisted of 48 600 individuals without MP. The follow-up period ran from the time of initial MP diagnosis to the date of an ACS event, censoring, or 31 December 2011. We analyzed the risk of ACS by using Cox proportional hazard regression models, including variables for sex, age and comorbidities. RESULTS The incidence of ACS was higher in MP patients than in comparison cohort (3.08 vs. 2.42 per 1000 person-years). The hazard ratio of developing ACS increased 37% in MP patients compared with that in the comparison cohort after adjustment for covariates. The effect of MP on subsequent ACS development appeared to 12 months after infection. CONCLUSION This nationwide study determined that compared with the general population, MP patients exhibited a 37% increase in the risk of subsequently developing ACS. Clinicians should be aware of this risk in MP patients and provide appropriate cardiovascular management in addition to MP treatment.
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Affiliation(s)
- W-S Chung
- From the Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Department of Health Services Administration, China Medical University, Department of Healthcare Administration, Central Taiwan University of Science and Technology
| | - W-H Hsu
- Department of Respiratory and Critical Care, China Medical University Hospital, Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University
| | - C-L Lin
- Management Office for Health Data, China Medical University Hospital, College of Medicine, China Medical University and
| | - C-H Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
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2
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Shimada K, Chen S, Dempsey PW, Sorrentino R, Alsabeh R, Slepenkin AV, Peterson E, Doherty TM, Underhill D, Crother TR, Arditi M. The NOD/RIP2 pathway is essential for host defenses against Chlamydophila pneumoniae lung infection. PLoS Pathog 2009; 5:e1000379. [PMID: 19360122 PMCID: PMC2660273 DOI: 10.1371/journal.ppat.1000379] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Accepted: 03/12/2009] [Indexed: 12/31/2022] Open
Abstract
Here we investigated the role of the Nod/Rip2 pathway in host responses to Chlamydophila pneumoniae–induced pneumonia in mice. Rip2−/− mice infected with C. pneumoniae exhibited impaired iNOS expression and NO production, and delayed neutrophil recruitment to the lungs. Levels of IL-6 and IFN-γ levels as well as KC and MIP-2 levels in bronchoalveolar lavage fluid (BALF) were significantly decreased in Rip2−/− mice compared to wild-type (WT) mice at day 3. Rip2−/− mice showed significant delay in bacterial clearance from the lungs and developed more severe and chronic lung inflammation that continued even on day 35 and led to increased mortality, whereas WT mice cleared the bacterial load, recovered from acute pneumonia, and survived. Both Nod1−/− and Nod2−/− mice also showed delayed bacterial clearance, suggesting that C. pneumoniae is recognized by both of these intracellular receptors. Bone marrow chimera experiments demonstrated that Rip2 in BM-derived cells rather than non-hematopoietic stromal cells played a key role in host responses in the lungs and clearance of C. pneumoniae. Furthermore, adoptive transfer of WT macrophages intratracheally was able to rescue the bacterial clearance defect in Rip2−/− mice. These results demonstrate that in addition to the TLR/MyD88 pathway, the Nod/Rip2 signaling pathway also plays a significant role in intracellular recognition, innate immune host responses, and ultimately has a decisive impact on clearance of C. pneumoniae from the lungs and survival of the infectious challenge. Chlamydophila pneumoniae (C. pneumoniae) is a common intracellular parasite that causes lung infections and contributes to several diseases characterized by chronic inflammation. Toll-like receptors expressed on the cell surface detect C. pneumoniae and mount a vigorous defense, but it is not known how the cell defends itself once the pathogen has taken up residence as a parasite. We reasoned that cytosolic pattern recognition receptors called Nods (nucleotide oligomerization domain) that detect microbes that gain entry into the cell might be involved. Using mice genetically deficient in Nod1 and Nod2 or their common downstream adaptor (Rip2), we show that in lung infection, Nod proteins are indeed essential in directing a defense against C. pneumoniae. Mice with defective Nod/Rip2-dependent signaling exhibited delayed recruitment of neutrophils, blunted production of pro-inflammatory cytokines and chemokines, and evidence of defective iNOS expression and NO production. These impaired responses led to delayed clearance of bacteria, intense persistent lung inflammation, and increased mortality. By performing bone marrow transplantation experiments and direct transfer of cells into the lungs of mice, we demonstrated that intact Nod-dependent signaling in bone marrow–derived cells was critical in the defense against C. pneumoniae. Our results indicate that Nod proteins also play an important role in host defense against C. pneumoniae. Coordinated and sequential activation of TLR and Nod signaling pathways may be necessary for an efficient immune response and host defense against C. pneumoniae.
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Affiliation(s)
- Kenichi Shimada
- Division of Pediatrics, Infectious Diseases, and Immunology, Cedars-Sinai Medical Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America
| | - Shuang Chen
- Division of Pediatrics, Infectious Diseases, and Immunology, Cedars-Sinai Medical Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America
| | - Paul W. Dempsey
- Department of Microbiology, Immunology, and Molecular Genetics, University of California Los Angeles, Los Angeles, California, United States of America
| | - Rosalinda Sorrentino
- Division of Pediatrics, Infectious Diseases, and Immunology, Cedars-Sinai Medical Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America
| | - Randa Alsabeh
- Division of Pathology & Laboratory Medicine, Cedars-Sinai Medical Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America
| | - Anatoly V. Slepenkin
- Department of Pathology, University of California Irvine, Irvine, California, United States of America
| | - Ellena Peterson
- Department of Pathology, University of California Irvine, Irvine, California, United States of America
| | - Terence M. Doherty
- Division of Pediatrics, Infectious Diseases, and Immunology, Cedars-Sinai Medical Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America
| | - David Underhill
- Immunology Research Institute, Cedars-Sinai Medical Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America
| | - Timothy R. Crother
- Division of Pediatrics, Infectious Diseases, and Immunology, Cedars-Sinai Medical Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America
| | - Moshe Arditi
- Division of Pediatrics, Infectious Diseases, and Immunology, Cedars-Sinai Medical Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America
- * E-mail:
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3
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Trumstedt C, Eriksson E, Lundberg AM, Yang TB, Yan ZQ, Wigzell H, Rottenberg ME. Role of IRAK4 and IRF3 in the control of intracellular infection withChlamydia pneumoniae. J Leukoc Biol 2007; 81:1591-8. [PMID: 17360955 DOI: 10.1189/jlb.0706456] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
TLR signal transduction involves a MyD88-mediated pathway, which leads to recruitment of the IL-1 receptor (IL-1R)-associated kinase 4 (IRAK4) and Toll/IL-1R translation initiation region domain-containing adaptor-inducing IFN-beta-mediated pathway, resulting in the activation of IFN regulatory factor (IRF)3. Both pathways can lead to expression of IFN-beta. TLR-dependent and -independent signals converge in the TNF receptor-associated factor 6 (TRAF6) adaptor, which mediates the activation of NF-kappaBeta. Infection of murine bone marrow-derived macrophages (BMM) with Chlamydia pneumoniae induces IFN-alpha/beta- and NF-kappaBeta-dependent expression of IFN-gamma, which in turn, will control bacterial growth. The role of IRAK4 and IRF3 in the regulation of IFN-alpha/beta expression and NF-kappaBeta activation was studied in C. pneumoniae-infected BMM. We found that levels of IFN-alpha, IFN-beta, and IFN-gamma mRNA were reduced in infected IRAK4(-/-) BMM compared with wild-type (WT) controls. BMM also showed an IRAK4-dependent growth control of C. pneumoniae. No increased IRF3 activation was detected in C. pneumoniae-infected BMM. Similar numbers of intracellular bacteria, IFN-alpha, and IFN-gamma mRNA titers were observed in C. pneumoniae-infected IRF3(-/-) BMM. On the contrary, IFN-beta(-/-) BMM showed lower IFN-alpha and IFN-gamma mRNA levels and higher bacterial titers compared with WT controls. C. pneumoniae infection-induced activation of NF-kappaBeta and expression of proinflammatory cytokines were shown to be TRAF6-dependent but did not require IRAK4 or IRF3. Thus, our data indicate that IRAK4, but not IRF3, controls C. pneumoniae-induced IFN-alpha and IFN-gamma secretion and bacterial growth. IRAK4 and IRF3 are redundant for infection-induced NF-kappaB activation, which is regulated by TRAF6.
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Affiliation(s)
- Christian Trumstedt
- Microbiology and Tumor Biology Center, Karolinska Institute, Nobels väg 16, 171 77 Stockholm, Sweden
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4
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Ott SJ, El Mokhtari NE, Musfeldt M, Hellmig S, Freitag S, Rehman A, Kühbacher T, Nikolaus S, Namsolleck P, Blaut M, Hampe J, Sahly H, Reinecke A, Haake N, Günther R, Krüger D, Lins M, Herrmann G, Fölsch UR, Simon R, Schreiber S. Detection of diverse bacterial signatures in atherosclerotic lesions of patients with coronary heart disease. Circulation 2006; 113:929-37. [PMID: 16490835 DOI: 10.1161/circulationaha.105.579979] [Citation(s) in RCA: 265] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Bacterial infection has been discussed as a potential etiologic factor in the pathophysiology of coronary heart disease (CHD). This study analyzes molecular phylogenies to systematically explore the presence, frequency, and diversity of bacteria in atherosclerotic lesions in patients with CHD. METHODS AND RESULTS We investigated 16S rDNA signatures in atherosclerotic tissue obtained through catheter-based atherectomy of 38 patients with CHD, control material from postmortem patients (n=15), and heart-beating organ donors (n=11) using clone libraries, denaturating gradient gel analysis, and fluorescence in situ hybridization. Bacterial DNA was found in all CHD patients by conserved PCR but not in control material or in any of the normal/unaffected coronary arteries. Presence of bacteria in atherosclerotic lesions was confirmed by fluorescence in situ hybridization. A high overall bacterial diversity of >50 different species, among them Staphylococcus species, Proteus vulgaris, Klebsiella pneumoniae, and Streptococcus species, was demonstrated in >1500 clones from a combined library and confirmed by denaturating gradient gel analysis. Mean bacterial diversity in atheromas was high, with a score of 12.33+/-3.81 (range, 5 to 22). A specific PCR detected Chlamydia species in 51.5% of CHD patients. CONCLUSIONS Detection of a broad variety of molecular signatures in all CHD specimens suggests that diverse bacterial colonization may be more important than a single pathogen. Our observation does not allow us to conclude that bacteria are the causative agent in the etiopathogenesis of CHD. However, bacterial agents could have secondarily colonized atheromatous lesions and could act as an additional factor accelerating disease progression.
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Affiliation(s)
- Stephan J Ott
- Institute for Clinical Molecular Biology, Department of General Internal Medicine, UKSH Campus Kiel, Kiel, Germany
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5
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Danesh J, Appleby P. Persistent infection and vascular disease: a systematic review. Expert Opin Investig Drugs 2005; 7:691-713. [PMID: 15991962 DOI: 10.1517/13543784.7.5.691] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
More than 150 epidemiological or clinical studies have reported on associations between vascular disease and the presence of certain persistent bacterial and viral agents, or of clinical conditions (e.g., periodontal disease) that are associated with persistent infection. This article provides a review of such studies, particularly in relation to Helicobacter pylori, Chlamydia pneumoniae, dental disease and cytomegalovirus (CMV), as well as references to possible mechanisms. The association between coronary heart disease and H. pylori or between heart disease and dental disease may be accounted for by residual confounding. Although markers of C. pneumoniae infection are around twenty times more common in atherosclerotic plaques than in disease-free blood vessels, the sequence of infection and disease is uncertain. For CMV, a limited number of patients with classic atherosclerotic coronary heart disease have been investigated in seroepidemiological studies. For all such agents, better and larger seroepidemiological and pathology-based studies are needed to resolve these uncertainties, as well as - at some stage - large-scale, randomised intervention studies.
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Affiliation(s)
- J Danesh
- Clinical Trial Service Unit, Nuffield Department of Clinical Medicine, Radcliffe Infirmary, Oxford, OX2 6HE, UK.
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6
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Rothfuchs AG, Trumstedt C, Wigzell H, Rottenberg ME. Intracellular bacterial infection-induced IFN-gamma is critically but not solely dependent on Toll-like receptor 4-myeloid differentiation factor 88-IFN-alpha beta-STAT1 signaling. THE JOURNAL OF IMMUNOLOGY 2004; 172:6345-53. [PMID: 15128825 DOI: 10.4049/jimmunol.172.10.6345] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Infection of murine bone marrow-derived macrophages (BMMphi) with Chlamydia pneumoniae induces IFN-alphabeta-dependent IFN-gamma secretion that leads to control of the intracellular bacterial growth. Enhanced growth of C. pneumoniae in Toll-like receptor (TLR) 4(-/-) and myeloid differentiation factor (MyD) 88(-/-) (but not TLR2(-/-), TLR6(-/-), or TLR9(-/-)) BMMphi is shown in this study. Reduced accumulation of IFN-alpha and IFN-gamma mRNA was also observed in TLR4(-/-)- and MyD88(-/-)-infected cells. IL-1R and IL-18R signaling did not account for differences between MyD88(-/-) and wild-type BMMphi. Surprisingly, infection-induced NF-kappaB activation as well as TNF-alpha, IL-1, or IL-6 mRNA expression were all normal in TLR4(-/-) and MyD88(-/-) cells. Phosphorylation of the transcription factor STAT1 during bacterial infection is IFN-alphabeta dependent, and necessary for increased IFN-gamma mRNA accumulation and chlamydial growth control. Signaling through common cytokine receptor gamma-chain and RNA-dependent protein kinase both mediated IFN-alphabeta-dependent enhancement of IFN-gamma mRNA levels. Accumulation of IFN-gamma mRNA and control of C. pneumoniae growth required NF-kappaB activation. Such NF-kappaB activation was independent of IFN-alphabeta, STAT1, and RNA-dependent protein kinase. In summary, C. pneumoniae-induced IFN-gamma expression in BMMphi is controlled by a TLR4-MyD88-IFN-alphabeta-STAT1-dependent pathway, as well as by a TLR4-independent pathway leading to NF-kappaB activation.
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MESH Headings
- Adaptor Proteins, Signal Transducing
- Animals
- Antigens, Differentiation/genetics
- Antigens, Differentiation/physiology
- Bone Marrow Cells/immunology
- Bone Marrow Cells/metabolism
- Cell Line, Tumor
- Cells, Cultured
- Chlamydophila pneumoniae/growth & development
- Chlamydophila pneumoniae/immunology
- DNA-Binding Proteins/deficiency
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/physiology
- Humans
- Interferon Type I/physiology
- Interferon-alpha/biosynthesis
- Interferon-alpha/genetics
- Interferon-gamma/biosynthesis
- Interferon-gamma/genetics
- Interleukin Receptor Common gamma Subunit
- Intracellular Fluid/immunology
- Intracellular Fluid/microbiology
- Macrophages/immunology
- Macrophages/metabolism
- Membrane Glycoproteins/deficiency
- Membrane Glycoproteins/genetics
- Membrane Glycoproteins/physiology
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Myeloid Differentiation Factor 88
- NF-kappa B/metabolism
- NF-kappa B/physiology
- RNA, Messenger/biosynthesis
- Receptors, Cell Surface/deficiency
- Receptors, Cell Surface/genetics
- Receptors, Cell Surface/physiology
- Receptors, Immunologic/deficiency
- Receptors, Immunologic/genetics
- Receptors, Immunologic/physiology
- Receptors, Interleukin-7/deficiency
- Receptors, Interleukin-7/genetics
- Receptors, Interleukin-7/physiology
- STAT1 Transcription Factor
- Signal Transduction/genetics
- Signal Transduction/immunology
- Toll-Like Receptor 2
- Toll-Like Receptor 4
- Toll-Like Receptor 9
- Toll-Like Receptors
- Trans-Activators/deficiency
- Trans-Activators/genetics
- Trans-Activators/physiology
- eIF-2 Kinase/physiology
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7
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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.
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8
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Lizard G, Gambert P. [Implication and mode of action of infectious agents in the formation of atheromatous plaques. Infection and atherosclerosis]. PATHOLOGIE-BIOLOGIE 2001; 49:824-9. [PMID: 11776694 DOI: 10.1016/s0369-8114(01)00224-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Different kinds of infectious agents seem to be implied in the atherosclerotic process. Indeed, some bacteria and viruses have been identified in atherosclerotic lesions: Chlamydia pneumoniae, Helicobacter pylori, Streptococcus sanguis, Porphyromonas gingivalis, herpes simplex viruses type 1 and 2, coxsakievirus B and hepatitis virus A. By their ability to induce antigenic and functional changes in the cells of the vascular wall (endothelial cells, smooth muscle cells, monocytes/macrophages, and fibroblasts) and to stimulate immune response as well as oxidative stress, it is more and more tempting to speculate that infectious agents probably play key roles in the initiation and in the formation of atherosclerotic plaques in certain patients.
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Affiliation(s)
- G Lizard
- Laboratoire de biochimie médicale, Inserm U 498, CHU hôpital du Bocage, BP 1542, 21034 Dijon, France.
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9
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Linares-Palomino J, Gutiérrez-Fernández J, López-Espada C, Ros-Díe E, Moreno-Escobar J, Pérez T, Rodríguez-Fernández M, Maroto-Vela MC. Chlamydia pneumoniae y enfermedad cerebrovascular. ANGIOLOGIA 2001. [DOI: 10.1016/s0003-3170(01)74680-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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10
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Szewczenko-Pawlikowski M, Kozak W. Accumulation of unsaturated lipids in monocytes during early phase pyrogen tolerance. BIOCHIMICA ET BIOPHYSICA ACTA 2000; 1484:183-94. [PMID: 10760468 DOI: 10.1016/s1388-1981(00)00016-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This paper presents data that inspired a new explanation for the mechanism of early phase endotoxin tolerance. Rabbits injected intravenously with LPS from Salmonella abortus developed a two-phase fever (6 h) and monophasic hyperlipidemia of very low density lipoproteins (two consecutive days). If during these days rabbits were injected with the same dose of LPS at 24-h intervals, the second phase of fever disappeared, i.e. early phase pyrogenic tolerance was obtained. This was correlated with a decrease of lipoprotein hyperlipidemia (measured 1.5 h after LPS injection) and an accumulation of lipids rich in double bonds in monocytes (measured 3.5 h after LPS injection). Results showed that the degree of unsaturation of acyl chains (AC) in monocytes (AC/DB, DB=double bonds) is negatively correlated (r=-0.72) with fever response (fever index). The authors maintain that a gradual increase in monocyte membrane fluidity is an adaptation to repeated exposure of monocytes to lipid A and is responsible for the progressive desensitization of monocytes to endotoxin. It is suggested that disorders of this mechanism lead to an accumulation of abnormal quantities of saturated lipids and cholesterol within macrophages, which, as foam cells, are the starting point for atherosclerosis pathology.
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Affiliation(s)
- M Szewczenko-Pawlikowski
- Department of Anatomy and Cell Biology, University of Toronto, 1 King's College Circle, Toronto, Ont., Canada.
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11
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Kaftan AH, Kaftan O. Coronary artery disease and infection with chlamydia pneumonia. JAPANESE HEART JOURNAL 2000; 41:165-72. [PMID: 10850532 DOI: 10.1536/jhj.41.165] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The association between chlamydia pneumonia and coronary artery disease is well documented, however less is known about the correlation between chlamydia pneumonia infection and blood inflammatory markers or lipid levels. In 100 patients with proven coronary artery disease (25 females, 61.0 +/- 4.0 years old), and 60 healthy volunteer control cases (15 females, 60.6 +/- 3.4 years old), anti chlamydia pneumonia IgG, blood lipid, C-reactive protein and fibrinogen levels were detected. In cases with coronary artery disease seropositivity for IgG antibodies to chlamydia pneumonia (74% versus 34%, p < 0.0001), C-reactive protein (mg / l) (2.8 +/- 0.6 versus 1.4 +/- 0.6; p < 0.0001), fibrinogen (mg / dl) (317.4 +/- 38.2 versus 256.2 +/- 34.5, p < 0.0001), triglyceride (mg / dl) (217.5 +/- 39.0 versus 191.0 +/- 25.9, p < 0.0001), LDL-cholesterol (mg / dl) (126.9 +/- 19.2 versus 110.6 +/- 19.5, p < 0.0001) levels and total cholesterol / HDL-cholesterol ratio (7.7 +/- 1.8 versus 4.4 +/- 1.2, p < 0.0001) were higher but the level of HDL-cholesterol (mg / dl) (26.4 +/- 6.7 versus 47.0 +/- 11.2, p < 0.0001) was lower. The levels of total cholesterol did not differ between the two groups (p=0.9). Levels of triglyceride (r=0.60, p < 0.00001), LDL-cholesterol (r = 0.27, p = 0.0004), C-reactive protein (r = 0.69, p < 0.00001), fibrinogen (r = 0.60, p < 0.00001) and total cholesterol / HDL-cholesterol ratio (r = 0.74, p < 0.00001) had a direct relation, but the level of HDL-cholesterol had a negative (r= -0.80, p < 0.00001) relation with the seropositivity for chlamydia pneumonia. As a result, seropositivity for IgG antibodies to chlamydia pneumonia is considered as a risk factor for coronary artery disease by its association with the atherogenic lipid profile and procoagulant activity.
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Affiliation(s)
- A H Kaftan
- University of Pamukkale, Faculty of Medicine, Department of Cardiology, Denizli, Turkey
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12
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Gnarpe J, Gnarpe H, Nissen K, Haldar K, Nääs J. Chlamydia pneumoniae infection associated with multi-organ failure and fatal outcome in a previously healthy patient. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1999; 30:523-4. [PMID: 10066059 DOI: 10.1080/00365549850161584] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Chlamydia pneumoniae has been associated with respiratory infections and with cardiovascular disease. We describe here a patient with multi-organ failure and fatal outcome in whom C. pneumoniae was implicated as a causative agent. Serological analysis for C. pneumoniae was done by immunofluorescence. Immunohistochemistry was carried out with avidin-biotin peroxidase staining. The patient had pneumonia I month prior to death. C. pneumoniae was detected in the heart and lungs by immunohistochemistry at autopsy. The patient had an antibody pattern suggestive of current or chronic C. pneumoniae infection. Serological analysis for Legionella sp., Mycoplasma pneumoniae, CMV, EBV, enteroviral agents and markers for autoimmune disease were negative. The findings suggest C. pneumoniae as the aetiological agent in this case of multi-organ failure.
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Affiliation(s)
- J Gnarpe
- Department of Clinical Microbiology, Gävle Central Hospital, Sweden
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13
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Lutwick LI. Unconventional vaccine targets. Immunization for pregnancy, peptic ulcer, gastric cancer, cocaine abuse, and atherosclerosis. Infect Dis Clin North Am 1999; 13:245-64, ix. [PMID: 10198802 DOI: 10.1016/s0891-5520(05)70053-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Vaccine technology can be applied to targets of intervention that currently have not been considered preventable by immunization. Targets include some diseases caused by, or related to, infectious agents, and other conditions clearly unassociated with disease pathogens. This article considers vaccines for pregnancy, peptic ulcer disease, gastric cancer, cocaine abuse and atherosclerosis.
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Affiliation(s)
- L I Lutwick
- Department of Medicine, VA Medical Center, Brooklyn, New York, USA
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14
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Murray LJ, O'Reilly DP, Ong GM, O'Neill C, Evans AE, Bamford KB. Chlamydia pneumoniae antibodies are associated with an atherogenic lipid profile. Heart 1999; 81:239-44. [PMID: 10026343 PMCID: PMC1728950 DOI: 10.1136/hrt.81.3.239] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To determine, within a representative population group of men and women, whether alteration of the lipid profile might underlie the reported association between Chlamydia pneumoniae and ischaemic heart disease. DESIGN AND SETTING Cross sectional survey in an area with a high incidence of ischaemic heart disease. SUBJECTS 400 randomly selected participants in the World Health Organisation MONICA project's third population survey in Northern Ireland. MAIN OUTCOME MEASURES Stored sera were examined by microimmunofluorescence for IgG antibodies to C pneumoniae at a dilution of 1 in 64. Mean total and high density lipoprotein (HDL) cholesterol were compared between seropositive and seronegative individuals with adjustment for age, measures of socioeconomic status, smoking habit, alcohol consumption, body mass index, and the season during which blood had been taken. RESULTS In seropositive men, adjusted mean serum total cholesterol and HDL cholesterol were 0.5 mmol/l (9.2%) higher and 0.11 mmol/l (9.3%) lower, respectively, than in seronegative men. Differences in women did not achieve statistical significance, but both total cholesterol and HDL cholesterol were higher (3.6% and 5.8%, respectively) in seropositive than in seronegative individuals. CONCLUSIONS There is serological evidence that C pneumoniae infection is associated with an atherogenic lipid profile in men. Altered lipid levels may underlie the association between C pneumoniae and ischaemic heart disease.
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Affiliation(s)
- L J Murray
- Department of Epidemiology and Public Health, The Queen's University of Belfast, Mulhouse Building, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, UK.
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Bartels C, Maass M, Bein G, Malisius R, Brill N, Bechtel JF, Sayk F, Feller AC, Sievers HH. Detection of Chlamydia pneumoniae but not cytomegalovirus in occluded saphenous vein coronary artery bypass grafts. Circulation 1999; 99:879-82. [PMID: 10027809 DOI: 10.1161/01.cir.99.7.879] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND A causal relation between atherosclerosis and chronic infection with Chlamydia pneumoniae and/or cytomegalovirus (CMV) has been suggested. Whether the unresolved problem of venous coronary artery bypass graft occlusion is related to infection with C pneumoniae and/or CMV has not been addressed. METHODS AND RESULTS Thirty-eight occluded coronary artery vein grafts and 20 native saphenous veins were examined. Detection of C pneumoniae DNA was performed by use of nested polymerase chain reaction (PCR). Homogenisates from the specimen were cultured for identification of viable C pneumoniae. Both conventional PCR and quantitative PCR for detection of CMV DNA were applied. Differential pathological changes (degree of inflammation, smooth muscle cell proliferation [MIB-1]) were determined and correlated to the detection of both microorganisms. C pneumoniae DNA could be detected in 25% of occluded vein grafts. Viable C pneumoniae was recovered from 16% of occluded vein grafts. Except for 1 native saphenous vein, all control vessels were negative for both C pneumoniae detection and culture. All pathological and control specimens were negative for CMV DNA detection. Pathological changes did not correlate with C pneumoniae detection. CONCLUSIONS Occluded aorto-coronary venous grafts harbor C pneumoniae but not CMV. The detection of C pneumoniae in occluded vein grafts warrants further investigation.
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Affiliation(s)
- C Bartels
- Clinic for Cardiac Surgery, Institute of Medical Microbiology, University of Luebeck, Luebeck, Germany
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Veller M, Shor A. The role of Chlamydia pneumoniae in the pathogenesis of atherosclerosis. Eur J Vasc Endovasc Surg 1998; 16:459-61. [PMID: 9894482 DOI: 10.1016/s1078-5884(98)80233-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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