Chlamydia pneumoniae but Not Cytomegalovirus Antibodies Are Associated With Future Risk of Stroke and Cardiovascular Disease

Abstract

Background and Purpose-Several cross-sectional and prospective studies have indicated that high titers of antibodies toChlamydia pneumoniae and cytomegalovirus (CMV) are associated with coronary heart disease. The aim of the present study was to examine whether elevated titers of antibodies to these pathogens are predictive of not only coronary but also cerebrovascular disease. Methods-Serum titers of antibodies to C pneumoniae (IgM, IgG, IgA, IgG immune complex) and CMV (IgG) were determined at baseline (nϭ130) and after 3.5 years (nϭ111) in a total sample of 152 men. All individuals had treated hypertension and at least 1 additional risk factor for cardiovascular disease (hypercholesterolemia, smoking, or diabetes mellitus) and constituted 93% of a randomly selected subgroup (nϭ164) of patients participating in a multiple risk factor intervention study. Results-Elevations of any or both of the IgA or IgG titers to C pneumoniae at entry or after 3.5 years were found in 84 cases (55%). Of those with high titers at entry, 97% remained high at the 3.5 year reexamination. After 6.5 years of follow-up, high titers to C pneumoniae at entry were associated with an increased risk for future stroke (relative risk

Role of Infectious and Immune Factors in Coronary and Cerebrovascular Arteriosclerosis

“…Dis. 11:106), whereas others did not (16,27,41,64,98). These conflicting data are again explained by methodological causes (17).…”

Multiple Infections and Subsequent Cardiovascular Events in the Heart Outcomes Prevention Evaluation (HOPE) Study

“…Serum was assayed for C pneumoniae IgG and IgA antibodies by microimmunofluorescence (MIF) end-point titration as described previously. 21,22 Doubling dilutions of sera in PBS, pH 7.4, were incubated overnight at 4°C with C pneumoniae antigen (LabSystems Oy), conjugated for 30 minutes at 37°C with FITC-conjugated anti-human IgG or IgA (Dakopatts). All sera found to be positive for IgA in a screening test were treated with GullSorb (Gull Laboratories) to remove IgG antibodies, then retested.…”

Primary Prevention of Ischemic Stroke

“…263,264 The fact that seropositivity to Chlamydia does not seem to correlate to carotid atherosclerosis, as measured by duplex ultrasonography, 265,266 supports the notion that Chlamydia may participate in plaque progression and destabilization as opposed to initiation of atherosclerosis, which may be why there appears to be a relationship between serum antibody titers to C pneumoniae and stroke. [267][268][269][270] The benefit of eradicating C pneumoniae from carotid plaques with antibiotic therapy remains unclear. 271 Data linking infection with other pathogens, such as cytomegalovirus and herpes simplex virus, with atherosclerosis are not as robust as those for C pneumoniae.…”