Published Online
on June 9, 2003

A more recent version of this article appeared on June 24, 2003

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Submitted on November 6, 2002
Revised on May 6, 2003
Accepted on May 7, 2003

Antibody Response to Chlamydial Heat Shock Protein 60 Is Strongly Associated With Acute Coronary Syndromes

Luigi M. Biasucci MD^*, Giovanna Liuzzo MD, Alessandra Ciervo MD, Andrea Petrucca MD, Maddalena Piro MD, Dominick J. Angiolillo MD, Filippo Crea MD, Antonio Cassone MD, and Attilio Maseri MD

From the Institute of Cardiology, Universita' Cattolica, Roma (L.M.B., G.L., M.P., D.J.A., F.C.); Department of Bacteriology and Medical Mycology, Istituto Superiore di Sanità, Rome (A.C., A.P., A.C.); and Cardiothoracic and Vascular Department, Universita' Vita e Salute, Milan (A.M.), Italy.

^* To whom correspondence should be addressed. E-mail: lmbiasucci{at}virgilio.it.

Background--Heat shock proteins (HSPs) are a family of proteins with immunogenic and proinflammatory properties. Human and Chlamydia pneumoniae (Cp) HSP60 were found in patients with stable coronary disease.

Methods and Results--We measured the levels of anti-Cp-HSP60 and anti-Cp immunoglobulin G (IgG) in 179 patients with unstable angina, 40 with acute myocardial infarction, and 40 with stable angina (SA), as well as 100 control subjects. Forty-one patients with acute coronary syndromes (ACS) were also studied at follow-up. We also measured plasma levels of high-sensitivity C-reactive protein (hs-CRP) and troponin T (TnT). Seropositivity to Cp-HSP60 was found in 99% of ACS patients but in only 20% of SA patients and none of the control subjects. Seropositivity to Cp was detected in 67% of ACS patients, 60% of SA patients, and 30% of the control subjects. No differences in Cp-HSP60 IgG and in Cp IgG were observed between patients with myocardial infarction and patients with unstable angina. No correlation was found between Cp-HSP60 IgG, TnT, and hs-CRP or between IgG against Cp and hs-CRP. In ACS patients at follow-up, Cp-HSP60 IgG decreased from 0.88±0.25 to 0.45±0.14 arbitrary units (P<0.0001), becoming negative in 12 patients.

Conclusions--Seropositivity for Cp-HSP60 appears to be a very sensitive and specific marker of ACS, unrelated to Cp IgG antibody titers or hs-CRP and TnT levels. Its causal involvement in instability and its diagnostic role in ACS deserve further study.

Key words: angina • infarction • infection • inflammation

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