Chlamydia pneumoniae infection and cerebrovascular disease: a systematic review and meta-analysis

Abstract

BackgroundA wealth of published studies have been published on association between Chlamydia pneumoniae (C.pneumoniae) infection and cerebrovascular (CV) disease, but the results were inconsistent. This meta-analysis provides a systematic review of the available evidence from all serological and pathological studies of CV disease and C.pneumoniae.MethodsA comprehensive research was conducted of MEDLINE, EMBASE, CNKI, WanFang technological periodical database and reference lists of articles to identify eligible case-control and cohort studies. Odds radio (OR) was calculated for each study outcome. Random effect model was used as pooling method and publication bias was estimated for the results.ResultsFifty-two published studies that met criteria were selected. In case control studies, an association between C.pneumoniae infection and CV disease was revealed by serum specific IgG (OR, 1.61; 95% CI: 1.34 to 1.94), serum IgA (OR, 2.33; 95% CI: 1.76 to 3.08) and PCR technique of C.pneumoniae in peripheral blood cells (OR, 1.90; 95% CI: 1.17 to 3.07). No significant association was found in serum anti-C.pneumonae IgM seropositivity or in-situ-detection of C.pneumoniae in arterial biopsies with CV disease. Subgroup analysis by available studies suggested that C.pneumoniae may paly a role in atherosclerotic stroke, but be less significant in stroke of cardioembolism or other etiologies.ConclusionAssociation between C.pneumoniae infection and CV disease depends on the analytical method adopted, which seems stronger with stroke due to large artery atherosclerosis. Establishing a causal relationship between C.peumoniae infection and CV disease will require more prospective studies with combination of techniques and stratified by etiological subtypes.

Cytomegalovirus infection and atherosclerosis risk: A meta‐analysis

“…Chronic inflammation has widely been regarded as an important factor in the process of the development of AS. It has been supported by experimental studies showing that there are now numerous different infectious agents that have been linked with an acceleration of the development of atherosclerosis, for instance, Chlamydi pneumoniae , Helicobacter pylori , hepatitis C virus, cytomegalovirus, and human immunodeficiency virus . All of these pathogens may increase the release of atherosclerosis‐related factors through activating of inflammatory factors, oxidative stress, immune response, and other factors, thereby which promote the development process of atherosclerosis.…”

Lack of strong association of Chlamydia pneumoniae and atherosclerosis in a Jordanian population

“…Besides seroepidemiology, the contribution of C. pneumoniae to cardiovascular disease has also been debated in a range of studies, including histopathology, animal models, and clinical intervention trials [10,17]. For instance, while some studies pointed to little or no evidence for the presence of C. pneumoniae in atheromas, the majority of histopathological studies concluded that C. pneumoniae could be detected in atherosclerotic plaques, unlike in healthy arteries [10,[34][35][36].…”

“…Furthermore, C. pneumoniae has been shown to induce foam cell formation, smooth muscle cell multiplication, platelet aggregation, and production of reactive oxygen intermediates and cellular adhesion molecules [15,16]. Paradoxically, other in vivo and in vitro studies have failed to link C. pneumoniae with atherosclerosis [17] and, therefore, it remains controversial whether C. pneumoniae could actively play a role in vascular disease development or is an innocent bystander.…”

Hijacking and Use of Host Lipids by Intracellular Pathogens

“…Chlamydophila (Chlamydia) pneumoniae is responsible for outbreaks of community-acquired pneumonia, pharyngitis, and bronchitis (36). In addition, C. pneumonia has been reported to be involved in the development of atherosclerosis (37–39). Collectively, these diseases are a major global public health problem.…”