Confirmed previous infection with Chlamydia pneumoniae (TWAR) and its presence in early coronary atherosclerosis
Confirmed previous infection with Chlamydia pneumoniae (TWAR) and its presence in early coronary atherosclerosis
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DOI：
10.1161/01.cir.98.7.628
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发表时间：
1998-08-18
期刊：
影响因子：
37.8
通讯作者：
Grayston, JT
中科院分区：
文献类型：
--
作者：
Davidson, M;Kuo, CC;Grayston, JT
背景肺炎衣原体已被确定在冠状动脉粥样硬化，但伴随的血清抗体滴度一直不一致的积极和不可用的早期或先进的动脉粥样硬化lesions.Methods和Results-This回顾性调查进行了尸检前的血清标本和尸检组织从60土著阿拉斯加原住民在低风险的冠心病，根据其储存标本的潜在可用性进行选择。血清标本是在死亡前平均8.8年（范围0.7 - 26.2年）采集的，死亡发生在平均34.1岁（范围15 - 57岁），主要是非心血管原因（97%）。冠状动脉组织进行了独立的组织学检查，肺炎衣原体微生物和DNA，免疫细胞化学（ICC）和聚合酶链反应（PCR）与种特异性单克隆抗体和引物。微量免疫荧光检测储存血清中的种特异性IgG、伊加和IgM抗体。通过PCR（14，23%）或ICC（20，33%），在15名受试者（25%）的冠状动脉纤维脂质粥样硬化（凸起病变，Stary II型至V型）和7名受试者（11%）的早期平坦病变中鉴定出肺炎衣原体，常位于巨噬细胞泡沫细胞内。肺炎衣原体在IgG抗体水平大于或等于1：256 >8年前升高的动脉粥样硬化中的OR为6.1（95%CI，1.1至36.6），在调整多个潜在混杂变量（包括烟草暴露）后，所有冠状动脉组织的OR为9.4（95%CI，2.6至33.8）。结论肺炎衣原体感染的血清学证据经常先于最早期和更晚期的冠状动脉粥样硬化病变，这些病变含有这种细胞内病原体，表明慢性感染和冠心病的发展作用。
Background-Chlamydia pneumoniae has been identified in coronary atheroma, but concomitant serum antibody titers have been inconsistently positive and unavailable before the detection of early or advanced atherosclerotic lesions.Methods and Results-This retrospective investigation was performed on premortem serum specimens and autopsy tissue from 60 indigenous Alaska Natives at low risk for coronary heart disease, selected by the potential availability of their stored specimens. Serum specimens were drawn a mean of 8.8 years (range, 0.7 to 26.2 years) before death, which occurred at a mean age of 34.1 years (range, 15 to 57 years), primarily from noncardiovascular causes (97%). Coronary artery tissues were independently examined histologically and, for C pneumoniae organism and DNA, by immunocytochemistry (ICC) and polymerase chain reaction (PCR) with species-specific monoclonal antibody and primers. Microimmunofluorescence detected species-specific IgG, IgA, and IgM antibody in stored serum. C pneumoniae, frequently within macrophage foam cells, was identified in coronary fibrolipid atheroma (raised lesions, Stary types II through V) in 15 subjects (25%) and early flat lesions in 7 (11%) either by PCR (14, 23%) or ICC (20, 33%). The OR for C pneumoniae in raised atheroma after a level of IgG antibody greater than or equal to 1:256 >8 years earlier was 6.1 (95% CI, 1.1 to 36.6) and for all coronary tissues after adjustment for multiple potential confounding variables, including tobacco exposure, was 9.4 (95% CI, 2.6 to 33.8).Conclusions-Serological evidence for C pneumoniae infection frequently precedes both the earliest and more advanced lesions of coronary atherosclerosis that harbor this intracellular pathogen, suggesting a chronic infection and developmental role in coronary heart disease.