Is the Perceived Association between
            <i>Chlamydia pneumoniae</i>
            and Vascular Diseases Biased by Methodology?

Maraha, B.; Berg, Hans F.; Kerver, Marjolein; Kranendonk, Steef; Hamming, Jaap F.; Kluytmans, Jan; Peeters, Marcel; Zee, Anneke van der

doi:10.1128/jcm.42.9.3937-3941.2004

Cited by 12 publications

(17 citation statements)

References 49 publications

(28 reference statements)

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“…In a smaller, but similar, study SEEMUNGAL et al [39] found no relationship between C. pneumoniae DNA detection in the airway at exacerbation and exacerbation frequency. The reported discrepancy in PCR positivity on respiratory samples between the present study and that of BLASI et al [38] may be due to a number of reasons, including differences in PCR techniques used (real time instead of conventional, differences in DNA polymerases, decontamination with 2'-deoxyuridine-5'-triphosphate-uracil-DNA glycosylase, the use of specific probes, inclusion of sufficient controls and the use of molecular grade water) [35,36] and differences in study design and study population. In the current authors' view, real-time PCR is the current standard in the clinical microbiology laboratory, and the question of cross-contamination occurs whenever a nested PCR is performed.…”

Section: Discussioncontrasting

confidence: 47%

“…Although initial reports were positive, more recent reports, often prospectively designed and adjusted for known cardiovascular risk factors, showed a negative or weak positive association overall between seropositivity for C. pneumoniae and atherosclerosis. Methodology has a strong impact on the possible association between C. pneumoniae and atherosclerosis: detection of the link between C. pneumoniae and coronary artery disease depends on the serological methodology chosen [35][36][37].…”

Section: Discussionmentioning

confidence: 99%

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The role of atypical respiratory pathogens in exacerbations of chronic obstructive pulmonary disease

Diederen¹,

Valk²,

Kluytmans³

et al. 2007

European Respiratory Journal

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The aetiology of acute exacerbations of chronic obstructive pulmonary disease (COPD) is heterogeneous and still under discussion. Serological studies have suggested that Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila may play a role in acute exacerbations of COPD.The presence of these atypical pathogens in sputum samples was investigated in patients with stable COPD and with acute exacerbations of COPD using real-time PCR. The present study was part of a randomised, double-blind, single-centre study and a total of 248 sputum samples from 104 COPD patients were included. In total, 122 samples obtained during stable disease (stablestate sputa) and 126 samples obtained during acute exacerbations of COPD (exacerbation sputa) were tested.Of the 122 stable-state sputa, all samples were negative for M. pneumoniae and C. pneumoniae DNA, whereas one sample was positive for Legionella non-pneumophila DNA. Of the 126 exacerbation sputa, all samples were negative for M. pneumoniae and C. pneumoniae DNA, whereas one sample was positive for Legionella non-pneumophila DNA.The possible relationship between the presence of atypical pathogens and the aetiology of acute exacerbations in chronic obstructive pulmonary disease was investigated in patients with stable disease and in those with acute exacerbations using real-time PCR. No indication was found of a role for Legionella spp., Chlamydia pneumoniae or Mycoplasma pneumoniae in stable, moderately severe chronic obstructive pulmonary disease and in its exacerbations.

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Section: Discussioncontrasting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

The role of atypical respiratory pathogens in exacerbations of chronic obstructive pulmonary disease

Diederen¹,

Valk²,

Kluytmans³

et al. 2007

European Respiratory Journal

View full text Add to dashboard Cite

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“…In those studies, unspecific signals may be incorrectly interpreted as C. pneumoniae positive. This is particularly the case when regular Taq DNA polymerase rather than Amplitac Gold DNA polymerase is used (43). In 11 out of 33 studies reviewed by Maraha et al (43), the detection rate was 31.6% when gel electrophoresis only was used to visualize the amplicons.…”

Section: Detection Of C Pneumoniae In Atherosclerotic Arteries By Pcrmentioning

confidence: 99%

“…This is particularly the case when regular Taq DNA polymerase rather than Amplitac Gold DNA polymerase is used (43). In 11 out of 33 studies reviewed by Maraha et al (43), the detection rate was 31.6% when gel electrophoresis only was used to visualize the amplicons. In the 22 studies in which results were confirmed by hybridization, the detection rate was 24.5% (P ϭ 0.0009).…”

Section: Detection Of C Pneumoniae In Atherosclerotic Arteries By Pcrmentioning

confidence: 99%

“…In the 22 studies in which results were confirmed by hybridization, the detection rate was 24.5% (P ϭ 0.0009). Furthermore, contamination by environmental chlamydia-like organisms has been detected (43). In a great majority of studies, C. pneumoniae or its DNA was included as a positive control in each amplification run or was added to PCR-negative specimens in a repeat reaction for the detection of PCR inhibitors.…”

Section: Detection Of C Pneumoniae In Atherosclerotic Arteries By Pcrmentioning

confidence: 99%

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Involvement of Chlamydia pneumoniae in Atherosclerosis: More Evidence for Lack of Evidence

Ieven¹,

Hoymans

2005

J Clin Microbiol

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During the past 15 years, many studies have been devoted to the relationship of Chlamydia pneumoniae and atherosclerosis: the serologic link has been investigated, and chlamydial organisms have been detected in lesions by electron microscopy, immunohistochemistry, in vitro cultivation, PCR, or in situ hybridization; efforts have been made to produce atherosclerosis experimentally in animals by inoculation of C. pneumoniae and therapeutic trials in humans have been undertaken. Some studies conclude that C. pneumoniae is present in cases of atherosclerosis, while others deny this, splitting the medical community into believers and disbelievers. The question, being a scientific one, should be resolved on a rational basis. After Boman and Hammerschlag reviewed the problem in 2002 (Clin. Microbiol. Rev. 15:1-20, 2002), a number of new studies were published on the subject. In this review, we critically evaluate the available data for the evidence or lack of evidence of a causal relationship for C. pneumoniae in atherosclerosis based on diagnostic and therapeutic studies performed with humans between 1992 and 2003, thereby searching mainly for concordance of evidence arising from different approaches used by different groups, at different times, and under different circumstances. In 1988, Saikku et al. (61) reported that patients with coronary artery disease carry significantly more anti-Chlamydia pneumoniae immunoglobulin G (IgG) and IgA antibodies in their bloodstream than healthy controls. Since this initial study, a huge number of cross-sectional and case-control studies addressing the involvement of C. pneumoniae in atherosclerosis have been published. Several, but not all, of these studies found a similar positive association. Prospective studies, in which results were generally adjusted for the presence of traditional risk factors, seem to minimize the relationship between baseline C. pneumoniae IgG titers in the healthy population and the risk for a subsequent coronary event. Furthermore, the presence of elevated anti-C. pneumoniae antibodies in patients with preexisting vascular disease means no increased risk for future or recurrent cardiovascular events. SEROEPIDEMIOLOGIC STUDIESThis serologic link between C. pneumoniae and vascular diseases has been studied by the microimmunofluorescence (MIF) test and enzyme-linked immunosorbent assays (ELISAs). There is, however, accumulating evidence that Chlamydia serology is less specific than was first assumed. Cross-reactivity between C. pneumoniae and other Chlamydia species has been demonstrated with the MIF test. In addition, neither the serologic procedures nor the criteria for defining an infection with C. pneumoniae are standardized. A standardization workshop held in 2001 (18) recommended that the MIF test should be considered the only acceptable serologic test for Chlamydia and that an IgG titer of Ն1/16 indicates past exposure but that neither elevated IgA titers nor any other serologic marker may be used as a validated indicator of persistent or chronic ...

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Chlamydiaceae

Skwor

Dean

2012

Molecular Typing in Bacterial Infections

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Is the Perceived Association between Chlamydia pneumoniae and Vascular Diseases Biased by Methodology?

Cited by 12 publications

References 49 publications

The role of atypical respiratory pathogens in exacerbations of chronic obstructive pulmonary disease

The role of atypical respiratory pathogens in exacerbations of chronic obstructive pulmonary disease

Involvement of Chlamydia pneumoniae in Atherosclerosis: More Evidence for Lack of Evidence

Chlamydiaceae

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