Chlamydia pneumoniae DNA in peripheral blood mononuclear cells in dialysis patients, renal transplant recipients and healthy controls

Abstract

It has been suggested that infection with Chlamydia pneumoniae plays a role in the development and maintenance of atherosclerosis based on differences in the prevalence of antibodies against Chlamydia pneumoniae in patients with and without atherosclerotic lesions and on the presence of bacteria in atherosclerotic lesions. It is well known that patients undergoing chronic dialysis treatment and renal transplant recipients have a considerably increased risk of cardiovascular disease. In this study it is hypothesized that patients with these conditions have a higher prevalence of Chlamydia pneumoniae DNA in the white cells of the peripheral blood. Blood samples from 196 dialysis patients, 114 renal transplant recipients and 342 healthy controls were analysed with an in-house nested polymerase chain reaction (nPCR) and tested for the presence of Chlamydia pneumoniae DNA. The prevalence of Chlamydia pneumoniae DNA was significantly higher in dialysis patients (16.3%) than in healthy controls (8.5%, p < 0.01), whereas no significant difference was found between the prevalence in renal transplant recipients (9.6%) and healthy controls. The prevalence was not related to gender or age in either group, and it was the same in diabetics and non-diabetics. Dialysis patients have a higher prevalence of Chlamydia pneumoniae DNA than healthy controls. The lower prevalence of Chlamydia pneumoniae DNA in renal transplant recipients than in dialysis patients may be due to selection of dialysis patients with few or no cardiovascular complications for renal transplantation. Our results are consistent with the hypothesis that Chlamydia pneumoniae is associated with the pathogenesis of atherosclerosis.

Circulating Chlamydia pneumoniae DNA and advanced coronary artery disease

“…In this predominantly male study population the prevalence of circulating C. pneumoniae DNA was 5.9% in patients undergoing coronary angiography, which is in line with other reports of presence of C. pneumoniae DNA in PBCs of patients with CAD [16][17][18]. The presence of vascular C. pneumoniae DNA has been associated with the presence of viable organism [19,20].…”

Associations of serologic markers of infection and inflammation with vascular disease events and mortality in American dialysis patients

“…7,12,23 A recent report of more common detection of C. pneumoniae DNA in the peripheral blood of dialysis patients compared with healthy controls supports the finding that subclinical chlamydial infections, and not just antibodies, are common among people with ESRD on dialysis. 24 In contrast to the high prevalence of anti-H. pylori antibodies among elderly Americans without kidney failure, 22 we detected Hp-IgG in only a quarter of the study cohort. Lower frequencies of H. pylori seropositivity among dialysis patients compared with controls have been demonstrated in Japan, 25 and were corroborated by less common histological evidence of chronic gastric infection.…”

Causes and consequences of inflammation on anemia management in hemodialysis patients

“…Seropositivity to C. pneumoniae is common in hemodialysis patients, with immunoglobulin (Ig) A or IgG antibodies to C. pneumoniae detected in 59% to 68% of these individuals 9,12 . Furthermore, hemodialysis patients have been shown to have a significantly higher prevalence of C. pneumoniae DNA in peripheral white blood cells than in healthy controls (16.3% vs. 8.5%, P<0.01) 56 . An association has been suggested between chlamydial infection, atherosclerosis, and inflammation in hemodialysis patients, although it is unclear whether Chlamydia infection per se contributes to the increased cardiovascular risk in these patients 57…”