Elevated
            <i>Chlamydia pneumoniae</i>
            Antibodies, Cardiovascular Events, and Azithromycin in Male Survivors of Myocardial Infarction

Gupta, Sandeep; Leatham, E; Carrington, David; Mendall, Michael A.; Kaski, Juan Carlos; Camm, A. John

doi:10.1161/01.cir.96.2.404

Cited by 648 publications

(346 citation statements)

References 17 publications

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“…In agreement with our finding in EH, clinically significant associations with high levels of IgG antibodies to C. pneumoniae, but not with C. pneumoniae infection in which the levels of these antibodies are low, have been described in other cardiovascular diseases. [18][19][20] On the basis of these results, Neumann et al 18 who analysed the frequency of restenosis after coronary stenting in relation with the titer of IgG antibodies to C. pneumoniae, suggested that it is not the C. pneumoniae infection as such but the variable host response to infection that affects the clinical end point. We do not know whether the above-mentioned high levels of sIgGa-Cp in our population are the consequence of characteristics of the host response to infection or are the consequence of pathogen peculiarities.…”

Section: Discussionmentioning

confidence: 99%

Association of HLA-DRB3*0202 and serum IgG antibodies to Chlamydia pneumoniae with essential hypertension in a highly homogeneous population from Majorca (Balearic Islands, Spain)

Zabay¹,

Marco

Soler³

et al. 2005

J Hum Hypertens

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Separate studies investigating the relationship of essential hypertension (EH) with the HLA system and with Chlamydia pneumoniae (C. pneumoniae) infection have given conflicting results. Our aim was to clarify these relationships and determine whether the HLA system and C. pneumoniae infection interact with respect to the risk for EH. An association study (110 essential hypertensives and 107 controls) was conducted in a highly homogeneous population in the Balearic Island of Majorca (Spain). Molecular typing of HLA-B and HLA-DRB and quantification of serum levels of IgG antibodies to C. pneumoniae (sIgGa-Cp) were determined. Student's t-test, v 2 -statistics, logistic regression analysis, and general linear model ANOVA were used for statistical analysis. The results showed that EH was related with HLA-DRB3*0202 in the whole study population, and with levels of sIgGa-Cp463.5 BU/ ml in the group of individuals with sIgGa-Cp430 BU/ml (OR (95% CI) adjusted for obesity, familial history of EH and diabetes ¼ 2.06 (1.07-3.97), P ¼ 0.03, and ¼ 4.60 (1.06-19.90), P ¼ 0.04, respectively). The association between EH and sIgGa-Cp was observed in the DRB3*0202( þ ) individuals, but not in the DRB3*0202(À) subgroup (OR (95% CI) ¼ 11.14 (1.92-64.54), P ¼ 0.004, and ¼ 0.98 (0.22-4.43), P ¼ 0.64, respectively (P of the Mantel-Haenszel test for homogeneity of OR ¼ 0.06)). In our population, EH was positively associated with HLA-DRB3*0202 and with high levels of sIgGa-Cp. Moreover, a significant interaction of DRB3*0202 on the effect of sIgGa-Cp was observed, as the association of EH with these antibodies depended on the presence of DRB3*0202.

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Section: Discussionmentioning

confidence: 99%

Association of HLA-DRB3*0202 and serum IgG antibodies to Chlamydia pneumoniae with essential hypertension in a highly homogeneous population from Majorca (Balearic Islands, Spain)

Zabay¹,

Marco

Soler³

et al. 2005

J Hum Hypertens

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“…When the animals were treated with macrolides, however, these lesions did not develop 26 . Preliminary clinical randomized trials 27,28 that still await confirmation support a causal relation between Chlamydia pneumoniae and coronary artery disease.…”

Section: Original Articlementioning

confidence: 99%

Chlamydia pneumoniae and atherosclerosis. Identification of bacterial DNA in the arterial wall

Coutinho¹,

Nakamae²,

Menezes³

2000

Arq. Bras. Cardiol.

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Objective -The intracellular Gram-negative bacterium Chlamydia pneumoniae has been associated with atherosclerosis. The presence of Chlamydia pneumoniae has been investigated in fragments of the arterial wall with a technique for DNA identification. Methods -Atherosclerosis and its associated diseases (acute myocardial infarction and ischemic stroke) are important causes of morbidity and mortality in industrialized and developing countries. Differences in the prevalence of conventional risk factors (smoking, hypertension, and dyslipidemia), however, do not explain temporal and geographic variations in the prevalence and severity of these diseases. About one third of the individuals with atherosclerosis are estimated not to have any of these major risk factors. This resulted in the search for new risk factors, such as coagulation factors, inflammatory factors, and infectious agents.Atherosclerosis is an inflammatory disease 1 . According to the current theory of atherogenesis, this process begins with an "initial injury" that triggers an inflammatory response involving lymphocytes, macrophages, smooth muscle cells, and endothelial cells. Some of the triggers proposed for the initial injury in atherosclerosis include the following: carbon monoxide of cigarettes, hemodynamic friction upon the endothelium, hypercholesterolemia, oxidized LDL, and more recently, infectious agents such as herpesvirus, cytomegalovirus, Helicobacter pylori, and Chlamydia pneumoniae.The association of Chlamydia pneumoniae and coronary, carotid, and peripheral arterial disease has been described in several countries in diverse types of studies as follows: a) serum-epidemiological studies 2-6 ; b) anatomicopathological studies 7-17 ; and c) experimental studies [18][19][20][21][22] . Reports on cultivation of Chlamydia pneumoniae in fragments of arteries exist, showing the viability of the bacterium and its multiplication capacity in that type of environment 10,12 . In vitro studies have shown the ability of Chlamydia pneumoniae to infect smooth muscle cells, endothelial cells, and human macrophages [23][24][25] . Experiments in rabbits infected with Chlamydia pneumoniae showed the development of fatty streaks and lesions similar to atherosclerosis in the aorta 18 . When the animals were treated with macrolides, however, these lesions did not develop 26 . Preliminary clinical randomized trials 27,28 that still await confirmation support a causal relation between Chlamydia pneumoniae and coronary artery disease.

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“…En 1994, une autre série annonçait une association entre maladie coronaire et infection par Helicobacter pylori [6]. Publiés en 1997, deux essais cliniques pilotes [7,8] ont suggéré qu'un traitement antibiotique par macrolide améliore le pronostic de la maladie coronaire. Malgré leurs imperfections, ils ont grandement stimulé l'intérêt pour l'hypothèse infectieuse de l'athérosclérose, car ils faisaient miroiter ses potentialités thérapeutiques.…”

Section: Historique De L'hypothèse Infectieuseunclassified

“…: données incertaines ; ±: données contradictoires ; + à +++: arguments probants, de force croissante. [7,[26][27][28]. L'enthousiasme éveillé par les deux premières publications [7,8] mérite à présent d'être sérieusement modéré.…”

Section: Modèles Expérimentauxunclassified

See 1 more Smart Citation

Aspects infectieux de l’athérosclérose

Wyplosz

Capron

2004

Med Sci (Paris)

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Elevated Chlamydia pneumoniae Antibodies, Cardiovascular Events, and Azithromycin in Male Survivors of Myocardial Infarction

Abstract: An increased anti-Cp antibody titre may be a predictor for further adverse cardiovascular events in post-MI patients. Taking a short course of azithromycin may lower this risk, possibly by acting against Cp.

Cited by 648 publications

References 17 publications

Association of HLA-DRB3*0202 and serum IgG antibodies to Chlamydia pneumoniae with essential hypertension in a highly homogeneous population from Majorca (Balearic Islands, Spain)

Association of HLA-DRB3*0202 and serum IgG antibodies to Chlamydia pneumoniae with essential hypertension in a highly homogeneous population from Majorca (Balearic Islands, Spain)

Chlamydia pneumoniae and atherosclerosis. Identification of bacterial DNA in the arterial wall

Aspects infectieux de l’athérosclérose

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