(Circulation. 2000;101:2568.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Relationship of Chlamydia pneumoniae Infection to Severity of Human Coronary Atherosclerosis
From the Unit of Forensic Medicine, Department of Surgery (K.E., T.G.P.S., O.L.) and Unit of Infectious Diseases and Clinical Microbiology, Department of Medicine (C.P.), University of Uppsala, Uppsala, Sweden; and the Department of Medicine (J.L.M.), University of Florida, College of Medicine, Gainesville, Fla.
Correspondence to J.L. Mehta, MD, PhD, University of Florida College of Medicine, PO Box 100277, Gainesville, FL 32610-0277. E-mail mehta{at}medmac.ufl.edu
Background—Infection with Chlamydia pneumoniae has been postulated to play a pathogenic role in atherosclerosis. We examined the role of infection with C pneumoniae in relation to the extent of coronary atherosclerosis.
Methods and Results—Coronary atherosclerosis was graded microscopically on a postmortem basis in a blinded fashion in 60 subjects as mild (n=18) or severe (n=42) atherosclerosis. Serum antibodies to C pneumoniae were measured by microimmunofluorescence test. Paraffin-embedded coronary artery specimens were examined for the presence of chlamydia by use of a genus-specific direct immunofluorescence monoclonal antibody. Frozen coronary artery specimens were examined by immunoperoxidase for the presence of C pneumoniae by use of a specific monoclonal antibody RR-402. Direct immunofluorescence was reactive in 86% of cases with severe atherosclerosis but in only 6% of cases with mild atherosclerosis (P<0.01), whereas immunoperoxidase staining was reactive in 80% and 38% of cases with severe and mild atherosclerosis, respectively (P<0.01). Elevated IgG and IgA levels against C pneumoniae were not different in cases with severe and mild atherosclerosis (61% and 30% for severe atherosclerosis and 67% and 42% for mild atherosclerosis, respectively).
Conclusions—This study supports the hypothesis that intracellular infection with C pneumoniae may relate to the severity of atherosclerosis in some subjects. Serum antibody titers against C pneumoniae do not differentiate between severe and mild atherosclerosis.
Key Words: atherosclerosis • pathology • infection
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