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(Circulation. 2001;103:1613.)
© 2001 American Heart Association, Inc.

Clinical Investigation and Reports

Distribution of Chlamydia pneumoniae in the Human Arterial System and Its Relation to the Local Amount of Atherosclerosis Within the Individual

Aryan Vink, MD; Marieke Poppen; Arjan H. Schoneveld, BSc; Paul J. M. Roholl, PhD; Dominique P. V. de Kleijn, PhD; Cornelius Borst, MD, PhD; Gerard Pasterkamp, MD, PhD

From the Department of Cardiology, University Medical Center Utrecht (A.V., G.P., M.P., A.H.S., D.P.V. de K., C.B.), and Interuniversity Cardiology Institute of the Netherlands (A.V., G.P., M.P., A.H.S., D.P.V. de K.), Utrecht, and Laboratory for Pathology and Immunobiology, National Institute of Public Health and the Environment (P.J.M.R.), Bilthoven, The Netherlands.

Correspondence to Gerard Pasterkamp, MD, PhD, University Medical Center Utrecht, Experimental Cardiology Laboratory, Room G02-523, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. E-mail g.pasterkamp{at}hli.azu.nl

Background—Chlamydia pneumoniae has been suggested to play a role in the origin of atherosclerosis. We studied the prevalence of C pneumoniae at multiple locations in the arterial system within the same individual. Studying the association between atherosclerosis and C pneumoniae within the individual excludes confounding by interindividual variability.

Methods and Results—Postmortem, the presence in the intima/plaque and media of C pneumoniae membrane protein was determined by use of a C pneumoniae–specific monoclonal antibody. In 24 individuals, 33 arterial locations were studied (n=738 segments). Area stenosis was determined in adjacent cross sections. In all individuals, immunostaining of C pneumoniae was observed in 1 artery. The highest prevalences were observed in the abdominal aorta (67%), internal and common iliac arteries (41%), and coronary arteries (33%). The lowest prevalences were observed in the radial (0%) and cerebral (2%) arteries. Within the individual, area stenosis was larger in cross sections with immunoreactivity compared with cross sections without immunoreactivity (31.0±11.9% versus 14.3±6.1%, respectively; P<0.001). In the individual, immunoreactivity was observed in 15±10% of the arteries (range, 3% to 45%). Between individuals, the percentage of arteries with immunoreactivity to C pneumoniae was associated with the average area stenosis throughout the arterial system (r²=0.56, P<0.001).

Conclusions—C pneumoniae was mostly observed at locations that are related to clinically relevant features. Within the individual, the distribution of C pneumoniae is associated with the distribution of atherosclerosis. The role of the microorganism in atherosclerotic disease remains to be elucidated.

Key Words: atherosclerosis • Chlamydia pneumoniae • pathology

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