Chlamydia pneumoniae , Stroke, and Serological Associations

Abstract

There are now more arguments against than for a causal relationship between C. pneumoniae and atherosclerosis. Seroepidemiologic results are largely technique-dependent; PCR results show intra-and interlaboratory variability; methodological factors contribute to bias; and detection of C. pneumoniae fails when the specificity of the reaction is optimized. Immunohistochemical staining detects nonspecific compounds in atherosclerotic lesions, and secondary prevention trials are unsuccessful. The evidence for an association between a pathogen and a chronic disease should be based on concordance of evidence arising from different approaches applied by different groups, at different times, in different places, and under different circumstances. None of these conditions have been fulfilled in the case of C. pneumoniae and atherosclerosis. 1

Implications of antibodies to heat-shock proteins in ischemic heart disease

“…Therefore, a selection bias (that patients who underwent heart catheterization may differ from the population in general) cannot be excluded fully. Secondly, serology for C. pneumoniae is highly problematic in terms of specificity, reproducibility, and lack of agreement between different tests [24]. To check the specific C. pneumoniae IgG antibody response, we used the so-called 'gold standard' microimmunofluorescence test [25].…”

Immunoproteomic Identification and Serological Responses to Novel Chlamydia pneumoniae Antigens That Are Associated with Persistent C. pneumoniae Infections

“…The first study of Saikku et al (21) showing a link between coronary artery disease and serological evidence for a past infection with C. pneumoniae was followed by many others, and today the number of reports showing a positive association is similar to the number of reports that show the opposite. These inconsistencies can likely be attributed to the poor validity of current C. pneumoniae serodiagnosis (22)(23)(24)(25). Although the microimmunofluorescence (MIF) 4 assay-which is based on whole C. pneumoniae elementary body (EB)-is considered the "gold standard" for C. pneumoniae serology (26), the test suffers from subjective interpretation, cross-reactivity between different Chlamydia species, and high intra-as well as interlaboratory variations (22)(23)(24)(25)27).…”

“…These inconsistencies can likely be attributed to the poor validity of current C. pneumoniae serodiagnosis (22)(23)(24)(25). Although the microimmunofluorescence (MIF) 4 assay-which is based on whole C. pneumoniae elementary body (EB)-is considered the "gold standard" for C. pneumoniae serology (26), the test suffers from subjective interpretation, cross-reactivity between different Chlamydia species, and high intra-as well as interlaboratory variations (22)(23)(24)(25)27). Moreover, it does not correlate with the presence of C. pneumoniae in the host (7, 28 -31) and obviously cannot discriminate past from persistent infections.…”

Severity of Carotid Atherosclerosis Unrelated to <i>Chlamydia pneumoniae</i> Infection in Acute Ischemic Stroke Patients: A Clinicopathological Study

“…It is of note that laboratory diagnosis of CPN infections still lacks standardization [20]. Since MIF methodology for CPN serology was reported to be insufficient to estimate disease associations [21], we used a well-defined antigen-based ELISA system. The prevalence of IgG seropositivity (73%) was similar to that of the general population of this age.…”