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Xu X, Liu Z, Xiong W, Qiu M, Kang S, Xu Q, Cai L, He F. Combined and interaction effect of chlamydia pneumoniae infection and smoking on lung cancer: a case-control study in Southeast China. BMC Cancer 2020; 20:903. [PMID: 32962687 PMCID: PMC7510273 DOI: 10.1186/s12885-020-07418-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 09/15/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND This case-control study investigated the role of Chlamydia pneumoniae (Cpn) infection in the pathogenesis of lung cancer and the combined and interaction effect of Cpn infection, smoking, and various environmental factors. METHODS The study comprised 449 lung cancer patients and 512 age- and sex-matched healthy controls. All participants provided a 5 ml fasting peripheral venous blood sample for testing Cpn-specific IgG and IgA by using micro-immunofluorescence. Besides analyzing the associations between Cpn and lung cancer, combined effect analysis, logistic regression, and the Excel table made by Andersson were used to analyze the combined and interaction effects of Cpn and environmental factors on lung cancer. RESULTS Compared to those with no evidence of serum Cpn IgA or Cpn IgG, those with both Cpn IgG+ and IgA+ had 2.00 times the risk (95% CI: 1.34-3.00) of developing lung cancer. Cpn IgG+ or IgA+ was associated with a significantly increased risk of lung cancer among smokers; the adjusted odds ratio (OR) was 1.79 (95% CI: 1.10-2.91) and 2.27 (95% CI: 1.38-3.72), respectively. Those exposed to passive smoking with Cpn IgG+ or IgA+ also showed an increased risk of lung cancer; the adjusted OR was 1.82 (95% CI: 1.20-2.77) or 1.87 (95% CI: 1.22-2.87), respectively. Similar results were also observed among alcohol drinkers. Multiplicative and additive interactions were not observed between Cpn infection and environmental factors. The combined effects of Cpn IgG+ or IgA+ with smoking, passive smoking, and family history of cancer on lung cancer were determined. CONCLUSION Cpn infection is potentially associated with primary lung cancer in the Chinese Han population and has combined effects with smoking, passive smoking, and family history of cancer.
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Affiliation(s)
- Xin Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350108, China
| | - Zhiqiang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350108, China.,The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China.,The Liver Center of Fujian Province, Fujian Medical University, Fuzhou, 350025, China
| | - Weimin Xiong
- Department of Health and Quarantine, The Xiamen Customs of the People's Republic of China, Xiamen, 361001, China
| | - Minglian Qiu
- Department of Thoracic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China
| | - Shuling Kang
- Fuzhou Center for Disease Control and Prevention, Fuzhou, 350004, China.,Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350108, China
| | - Qiuping Xu
- Medical Department, The Affiliated Hospital of Putian University, Putian, 351100, China
| | - Lin Cai
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350108, China
| | - Fei He
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350108, China.
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Ishida K, Yamazaki T, Motohashi K, Kobayashi M, Matsuo J, Yamaguchi H, Yamamoto Y, Osaki T, Hanawa T, Kamiya S. Effect of the steroid receptor antagonist RU486 (mifepristone) on an IFNγ-induced persistent Chlamydophila pneumoniae infection model in epithelial HEp-2 cells. J Infect Chemother 2012; 18:22-9. [DOI: 10.1007/s10156-011-0274-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Accepted: 06/16/2011] [Indexed: 12/01/2022]
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Prior lung disease and lung cancer risk in an occupational-based cohort in Yunnan, China. Lung Cancer 2011; 72:258-63. [PMID: 21367481 DOI: 10.1016/j.lungcan.2011.01.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Revised: 01/23/2011] [Accepted: 01/28/2011] [Indexed: 11/21/2022]
Abstract
We used the data from a prospective cohort study among tin miners in Yunnan, China to investigate whether prior lung disease is a risk factor for lung cancer. Information on prior lung disease was obtained from baseline questionnaires. The Cox proportional hazards model was used to examine the relationship between prior lung disease and lung cancer risk. From 1992 to 2001, a total of 502 lung cancer cases were confirmed among 9295 cohort participants. Prior chronic bronchitis was associated with an increase in lung cancer risk with an adjusted HR of 1.50 (95% CI: 1.24-1.81). There was an increased risk of developing squamous cell carcinoma in the setting of prior chronic bronchitis and small cell carcinoma in association with asthma with an adjusted HRs of 1.57 (95% CI: 1.19-2.09) and 2.56 (95% CI: 1.38-4.75), respectively. This prospective study provides further evidence that prior chronic bronchitis correlates with increased lung cancer risk, especially for squamous cell carcinoma. Asthma is associated with increased risk of small cell lung carcinoma.
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Liang H, Guan P, Yin Z, Li X, He Q, Zhou B. Risk of lung cancer following nonmalignant respiratory conditions among nonsmoking women living in Shenyang, Northeast China. J Womens Health (Larchmt) 2010; 18:1989-95. [PMID: 20044861 DOI: 10.1089/jwh.2008.1355] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND There has been conflicting evidence about possible associations between nonmalignant respiratory conditions (NMRCs) and subsequent risk of lung cancer. Determination of whether or not there is such an association has potential importance for managing NMRCs, for screening of lung cancer, and for understanding mechanisms of carcinogenesis. METHODS A hospital-based, case-control study involving interviews with 226 female nonsmoking lung cancer patients and 279 matching population controls was conducted in Shenyang, Northeast China, between January 2004 and December 2007. A standardized interview collected information on a variety of potential risk factors, including a history of physician-diagnosed NMRCs (pulmonary tuberculosis, chronic bronchitis, emphysema, asthma, and bronchiectasis), and age/year in which each condition was first diagnosed. Multivariate logistic regression analyses were applied to assess the associations between NMRCs and subsequent lung cancer risk. RESULTS Compared with those without, subjects with a history of NMRC experience greater risk of lung cancer (OR=2.0, 95% CI 1.2-3.4), particularly following a diagnosis of pulmonary tuberculosis (OR=4.7, 95% CI 1.6-13.2). The results from subgroup analysis, when limited to small cell lung cancer, showed a 6.2-fold increase in lung cancer risk among asthmatics (95% CI 1.5-25.8). However, there was no evidence of a significant association between chronic bronchitis and lung cancer. CONCLUSIONS This study strengthens the evidence linking NMRCs, especially pulmonary tuberculosis, to lung cancer even in lifelong nonsmoking women.
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Affiliation(s)
- Huiying Liang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, PR China
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Bazzazi H, Ghaemi EA, Ramezani MA. The seroepidemiology of the chronic infections in patients with myocardial infarction in North of Iran. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2010; 15:116-9. [PMID: 21526068 PMCID: PMC3082792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2009] [Accepted: 11/09/2009] [Indexed: 11/05/2022]
Abstract
BACKGROUND Recent studies have suggested that chronic infections with Chlamydia pneumoniae (Cpn) and Helicobacter pylori (Hp) may be associated with the risk of Myocardial Infarction (MI). METHODS A cross sectional study was conducted on 140 citizens. Seroprevalence was assessed by ELISA tests measuring IgA and IgG antibodies to Cpn and Hp in sera. RESULTS Among patients, %11.4 and %90.0 were seropositive for Anti-Cpn IgA and IgG respectively, and also %51.4 and %58.6 were seropositive for Anti-Hp IgA and IgG respectively. CONCLUSIONS The present study shows that previous infection to Cpn in patients with MI is important. But there are no significant association between infection with Hp and MI.
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Affiliation(s)
- Hadi Bazzazi
- Department of Laboratory Sciences, Islamic Azad University, Gorgan Branch, Gorgan, Iran,* Corresponding Author E-mail:
| | - Ezzat Allah Ghaemi
- Associate Professor, Microbiology Department, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammad Ali Ramezani
- Associate Professor, Heart Department, Golestan University of Medical Sciences, Gorgan, Iran
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Smith JS, Kumlin U, Nyberg F, Fortes C, Zaridze D, Ahrens W, Bruske-Hohlfeld I, Constantinescu V, Ting J, Benhamou S, Simonato L, Boman J, Gaborieau V, Boffetta P. Lack of association between serum antibodies of Chlamydia pneumoniae infection and the risk of lung cancer. Int J Cancer 2008; 123:2469-71. [PMID: 18720403 DOI: 10.1002/ijc.23814] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Intragastric primary infection sensitizes to lung reinfection in a Chlamydia pneumoniae mouse model. Vaccine 2008; 26:2503-9. [DOI: 10.1016/j.vaccine.2008.03.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2007] [Revised: 02/27/2008] [Accepted: 03/11/2008] [Indexed: 11/19/2022]
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Chlamydia pneumoniae growth inhibition in cells by the steroid receptor antagonist RU486 (mifepristone). Antimicrob Agents Chemother 2008; 52:1991-8. [PMID: 18347111 DOI: 10.1128/aac.01416-07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Since steroids are powerful anti-inflammatory agents and increase susceptibility to a variety of infections, including Chlamydia (Chlamydophila) pneumoniae respiratory tract infections, the effect of the steroid receptor antagonist RU486 (mifepristone) on C. pneumoniae growth in epithelial HEp-2 cells was examined. Treatment of HEp-2 cells with RU486 significantly inhibited the growth of C. pneumoniae in a dose-dependent manner. Electron microscopic studies also revealed that the treatment of infected cells with RU486 resulted in a marked destruction of infecting organisms. The addition of the host cell protein synthesis inhibitor cycloheximide to the infected cells did not alter the inhibition of C. pneumoniae growth by RU486. Pretreatment of C. pneumoniae organisms with RU486 before addition to culture also did not result in any modulation of bacterial growth in the cells. However, the binding of RU486 to C. pneumoniae organisms in cells at 24 h after infection was demonstrated by immune electron microscopy with anti-RU486 antibody. Incubation of cells with anti-RU486 antibody completely diminished the inhibition of C. pneumoniae growth by RU486. These results indicate that RU486 may directly bind to the bacteria within cells and cause the destruction of C. pneumoniae. This novel mode of regulation of C. pneumoniae growth in cells by RU486 might provide a new approach to understanding complicated aspects of C. pneumoniae infection.
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Tiirola T, Jaakkola A, Bloigu A, Paldanius M, Sinisalo J, Nieminen MS, Silvennoinen-Kassinen S, Saikku P, Jauhiainen M, Leinonen M. Novel enzyme immunoassay utilizing lipopolysaccharide-binding protein as a capture molecule for the measurement of chlamydial lipopolysaccharide in serum. Diagn Microbiol Infect Dis 2006; 54:7-12. [PMID: 16290027 DOI: 10.1016/j.diagmicrobio.2005.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2005] [Indexed: 10/25/2022]
Abstract
Chlamydia pneumoniae causes respiratory tract infections. It has a tendency to cause persistent infections, which have been associated with several chronic diseases (e.g., atherosclerosis). At present, there is no reliable method for the diagnosis of chronic C. pneumoniae infection. We developed a novel enzyme immunoassay (EIA) for the quantification of chlamydial lipopolysaccharide (cLPS) in human serum. Serum cLPS was solubilized with detergent and then captured by LPS-binding protein (LBP). LBP-LPS complexes were bound to the solid phase with anti-cLPS monoclonal antibody, and the bound complexes were detected with anti-LBP antibodies. The new method was used to quantify serum cLPS in acute coronary syndrome (ACS) patients (n = 102) and their healthy controls. cLPS was detected in 77.5% of ACS patients and in 52% of controls (P < .001) with geometric mean concentrations of 1.87 and 0.61 microg/mL (P < .001), respectively. The novel cLPS EIA method will provide a potential diagnostic tool for C. pneumoniae infection.
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Affiliation(s)
- Terttu Tiirola
- Department of Molecular Medicine, National Public Health Institute, Biomedicum, PO Box 104, FIN-00251 Helsinki, Finland.
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Ciervo A, Petrucca A, Visca P, Cassone A. Evaluation and optimization of ELISA for detection of anti-Chlamydophila pneumoniae IgG and IgA in patients with coronary heart diseases. J Microbiol Methods 2004; 59:135-40. [PMID: 15325761 DOI: 10.1016/j.mimet.2004.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2004] [Revised: 05/28/2004] [Accepted: 05/28/2004] [Indexed: 11/17/2022]
Abstract
We have evaluated and optimized a commercial enzyme-linked immunosorbent assay (ELISA; SeroCP Savyon, Israel), using the commercial microimmunofluorescence test (MIF; Labsystems; Helsinki, Finland) as reference method. This was done for the detection of anti-Chlamydophila pneumoniae IgG and IgA antibodies in patients with coronary heart disease (CHD). After optimization, a good agreement between the ELISA and MIF tests [IgG (P(0.05)=0.0008 and r=0.93) and IgA (P(0.05)=0.00072 and r=0.72)] was found. These ELISA tests proved to be a useful semiquantitative method for seroprevalence studies in CHD patients, with remarkable advantages over MIF test in terms of objective measurement, thus reproducibility, performance and interpretation.
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Affiliation(s)
- Alessandra Ciervo
- Department of Infectious, Parasitic and Immune-mediated Diseases, Unit of Respiratory and Systemic Bacterial Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome 00161, Italy.
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Schumacher A, Seljeflot I, Lerkerød AB, Sommervoll L, Otterstad JE, Arnesen H. Positive Chlamydia pneumoniae serology is associated with elevated levels of tumor necrosis factor alpha in patients with coronary heart disease. Atherosclerosis 2002; 164:153-60. [PMID: 12119204 DOI: 10.1016/s0021-9150(02)00043-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Infectious agents are possible stimulators of inflammation in atherogenesis. The aim of this study was to investigate if Chlamydia pneumoniae and Helicobacter pylori were associated with elevated levels of tumor necrosis factor alpha (TNFalpha) and interleukin-6 in coronary heart disease (CHD) patients (n=193) and age- and sex-matched controls (n=193) as markers of increased inflammatory activity. C reactive protein (CRP) and fibrinogen were also included. Serologic status towards the two bacteria was measured and levels of the inflammatory markers were compared between seropositives and seronegatives, each study group being evaluated separately. In CHD patients Chlamydia lipopolysaccharide (LPS) IgA seropositivity predicted elevated TNFalpha levels (P=0.009), still statistically significant after adjustment for traditional cardiovascular risk factors (P=0.005). Chlamydia LPS IgG seropositivity independently predicted fibrinogen levels in CHD patients (P=0.028), while no association between serology and inflammatory markers were observed among controls. H. pylori seropositivity alone was not associated with any increase in the inflammatory markers in any of the two groups. However, in CHD patients seropositivity to both agents predicted higher levels of TNFalpha (P=0.041), CRP (P=0.037) and fibrinogen (P=0.001) compared to double seronegativity. We conclude that C. pneumoniae LPS seropositivity may contribute to increased vascular inflammation in CHD patients, possibly even more pronounced when present in combination with H. pylori seropositivity.
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Affiliation(s)
- A Schumacher
- Department of Microbiology and Department of Medicine, Vestfold Central Hospital, PB 2168 Postterminalen, 3103, Tonsberg, Norway.
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Airenne S, Surcel HM, Tuukkanen J, Leinonen M, Saikku P. Chlamydia pneumoniae inhibits apoptosis in human epithelial and monocyte cell lines. Scand J Immunol 2002; 55:390-8. [PMID: 11967121 DOI: 10.1046/j.1365-3083.2002.01075.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Chlamydia pneumoniae is an obligate intracellular pathogen with a tendency to cause persistent infections that has been associated with many chronic conditions such as asthma and coronary artery disease. However, its immunopathogenic mechanisms are poorly understood. When aiming to study the impact of C. pneumoniae infection on host cell apoptosis, we found that epithelial infected (HL) cells and macrophages (U937-line) were resistant to staurosporine and tumour necrosis factor (TNF)-alpha-induced physiological apoptosis 48, 72 or 120 h post-infection, as determined by flow cytometry, DNA fragmentation assay and fluorescence microscopy. The antiapoptotic influence was observed even at a late stage of the chlamydial life cycle and was dependent on the chlamydial protein synthesis. The mechanisms involved blockage of mitochondrial cytochrome c release and caspase 3 activation. We also found that during a persistent C. pneumoniae infection induced in vitro by penicillin treatment of cell cultures, the inhibition of apoptosis was extended for up to 120 h of follow-up post-infection and was restricted to the cells carrying chlamydial inclusions. Our findings suggest that inhibition of apoptosis may be one of the pathogenetic mechanisms by which C. pneumoniae infection can mediate the development of chronic diseases.
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Affiliation(s)
- S Airenne
- National Public Health Institute, Oulu, Finland.
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Ciervo A, Visca P, Petrucca A, Biasucci LM, Maseri A, Cassone A. Antibodies to 60-kilodalton heat shock protein and outer membrane protein 2 of Chlamydia pneumoniae in patients with coronary heart disease. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2002; 9:66-74. [PMID: 11777831 PMCID: PMC119896 DOI: 10.1128/cdli.9.1.66-74.2002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Evidence linking Chlamydia pneumoniae infection to atherosclerosis and to atherothrombotic events has recently emerged. A primary candidate implicated in these pathogenetic events is the 60-kDa chlamydial heat shock protein (HSP60). Another putative candidate to activate a potential proinflammatory mechanism is the chlamydial outer membrane protein 2 (OMP2). We have generated both HSP60 and OMP2 recombinant antigens in a nondenatured form and shown that (i) the two antigens were highly immunogenic in mice and (ii) murine antisera thus generated recognized the native C. pneumoniae proteins. We measured by enzyme linked immunosorbent assay (ELISA) and immunoblot assay antibody titers to the recombinant antigens in samples from 219 patients with coronary heart disease (CHD), 179 patients with unstable angina (UA), 40 patients with acute myocardial infarction (AMI), and 100 age-, sex-, and risk factor-matched healthy controls. We also examined whether anti-HSP60 and/or anti-OMP2 antibodies correlated with anti-C. pneumoniae antibodies assessed by a commercial microimmunofluorescence (MIF) assay. Immunoglobulin G (IgG), but neither IgA nor IgM, antibodies against the two recombinant proteins were detected by ELISA. In particular, anti-HSP60 antibodies were detected in >99% of CHD patients versus 0% of the controls, whereas the proportions of anti-OMP2 positive subjects were >70 and 27%, respectively. Nonetheless, among CHD patients, similar frequencies of positive subjects and titers of anti-HSP60 or anti-OMP2 antibodies were present in UA and AMI subjects. The anti-OMP2, but not the anti-HSP60, antibodies showed high specificity. Consistently, high serological correlation was observed between IgG MIF titers and IgG ELISA reactivity to OMP2 but not to HSP60. Overall, the results of this study demonstrate a strong correlation between CHD and anti-HSP60 IgG levels, as measured by our in-house ELISA. They also suggest that recombinant OMP2 ELISA, because of its high specificity and strong correlation with MIF assay, could be a candidate diagnostic marker for C. pneumoniae infection, which would be of potential usefulness for its specificity and nonsubjective nature.
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Affiliation(s)
- Alessandra Ciervo
- Department of Bacteriology and Medical Mycology, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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Tuuminen T, Palomäki P, Paavonen J. The use of serologic tests for the diagnosis of chlamydial infections. J Microbiol Methods 2000; 42:265-79. [PMID: 11044570 DOI: 10.1016/s0167-7012(00)00209-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Serology is commonly used for the diagnosis of acute Chlamydia pneumoniae infections and also for the diagnosis of complicated Chlamydia trachomatis infections. Furthermore, recent sero-epidemiological studies have linked C. pneumoniae infection with several diseases traditionally considered non-infectious. The objectives of this mini-review are to critically review and discuss some selected analytical and methodological aspects, controversies and current problems in chlamydial serodiagnosis. To illustrate our views we present some original data of the comparison of current technologies. The review of the literature revealed high variability in methodologies applied to different studies. This observation was supported by our own data, which explains occasional conflicting clinical interpretation. Although the microimmunofluorescence (MIF) technique is generally considered as the gold standard for serodiagnosis of chlamydial infections, assay conditions are highly variable and hence pose a major problem in the interpretation of the results. For instance, many recent studies linking C. pneumoniae and atherosclerosis have utilized MIF techniques with variable threshold criteria for the positivity, in combination with selection bias of cases and controls possibly leading to conflicting results. Variability of assay conditions is also a common problem with Western blots, and interpretation is problematic when both anti-C. pneumoniae and anti-C. trachomatis antibodies are present. Furthermore, there is a lot of disagreement in serological criteria applied to recently emerged enzyme immunoassay (EIA) techniques when these assays are used for acute and non-acute clinical conditions and their association with Chlamydiae. In conclusion, standardization of serological techniques and the development of uniform criteria for interpretation of serologic findings is necessary to increase our knowledge of the biology of Chlamydiae, pathogenesis of any chlamydial infection and chronic infections in particular.
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Affiliation(s)
- T Tuuminen
- Labsystems Research Laboratories, Labsystems OY, Sorvaajankatu 15, 00811, Helsinki, Finland.
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Kosaka C, Hara K, Komiyama Y, Takahashi H. Possible role of chronic infection with Chlamydia pneumoniae in Japanese patients with acute myocardial infarction. JAPANESE CIRCULATION JOURNAL 2000; 64:819-24. [PMID: 11110424 DOI: 10.1253/jcj.64.819] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Chlamydia pneumoniae, a common human respiratory pathogen, has been implicated in the pathogenesis of coronary heart diseases (CHD) in several seroepidemiological studies. The present case-control study investigated the relation between serologic evidence of C. pneumoniae infection and CHD in a Japanese population. Two groups of cases were enrolled: 26 patients with acute myocardial infarction (AMI) and 46 patients with effort angina pectoris (e-AP). Their data were compared with 58 age-matched healthy controls and also compared with 53 patients with vasospastic angina (VSA) as pathological control subjects. Anti-C. pneumoniae specific IgA and IgG antibody titers were measured by enzyme-linked immunosorbent assay (ELISA). The mean indices of IgG-type antibody in AMI and e-AP were not significantly different from those in either the normal controls or VSA group. On the other hand, the mean indices of IgA-type antibody in AMI were significantly higher than in the normal controls (1.39+/-0.83 in AMI vs 0.84+/-0.58 in controls, p<0.001) and VSA (1.39+/-0.83 in AMI vs 1.05+/-0.61 in VSA, p<0.05) group. However, the differences in the IgA titers in the e-AP group compared with the normal controls did not reach a significant level. The odds ratio associated with the seropositivity of IgA for AMI against the normal controls was 3.89 (95% confidence interval (CI): 1.16-13.10) and that against VSA was 6.90 (95% CI: 1.73-27.52) after adjustment for risk factors for CHD and/or age, sex and smoking status. In 6 patients the elevated IgA titers were sustained even at 3 months after the episode of AMI. These results suggest that seropositivity for IgA-type antibody against C. pneumoniae may be a significant risk factor for the development of AMI. The possible mechanisms include chronic inflammation in the coronary artery due to persistent C. pneumoniae infection.
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Affiliation(s)
- C Kosaka
- Department of Clinical Sciences and Laboratory Medicine, Kansai Medical University, Osaka, Japan
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Hahn DL, Peeling RW, Dillon E, McDonald R, Saikku P. Serologic markers for Chlamydia pneumoniae in asthma. Ann Allergy Asthma Immunol 2000; 84:227-33. [PMID: 10719781 DOI: 10.1016/s1081-1206(10)62760-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Chlamydia pneumoniae infection has been reported as a possible etiologic agent in asthma, which in primary care settings often appears to be initiated by acute respiratory infections. OBJECTIVE To determine if serologic markers for C. pneumoniae are associated with adult asthma that first became symptomatic after an acute respiratory illness (asthma associated with infection: AAWI). METHODS Serum samples from 164 primary care outpatients, mean age 44 years, (68 with AAWI; 36 with atopic, occupational or exercise-induced asthma (non-AAWI); 16 nonasthmatic patients with acute bronchitis; and 44 asymptomatic nonasthmatic controls) were tested for the presence of C. pneumoniae-specific IgG and IgA antibodies. Levels of chlamydial heat shock protein 60 (CHSP60) antibody were also measured. Those positive for CHSP60 were tested for C. pneumoniae-specific IgE antibodies by immunoblotting. RESULTS Statistically significant differences in IgG and IgA seroreactivity were noted between groups: acute bronchitis and AAWI had the highest levels (93% to 94% IgG seroreactivity, 69% to 75% IgA seroreactivity) whereas non-AAWI and asymptomatic controls had the lowest levels (61% to 84% IgG seroreactivity, 31% to 43% IgA seroreactivity, P < .02 after adjustment for age, sex and smoking). CHSP60 antibodies were significantly more prevalent in AAWI than in non-AAWI (19% versus 3%, P = .02). IgE antibodies against C. pneumoniae 60, 62, and/or 70 kD antigens were detected in 5 of 13 CHSP60 positive AAWI patients. Persistent IgG, IgA, and CHSP60 seroreactivities were noted in all seropositive asthma patients with serial serum samples. CONCLUSIONS Serologic markers of C. pneumoniae infection were associated with acute bronchitis and with asthma that first became symptomatic following respiratory illness. Serologic responses to C. pneumoniae may be useful in the classification and diagnosis of asthma.
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Affiliation(s)
- D L Hahn
- Dean Medical Center, Madison, Wisconsin, USA
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Abstract
LEARNING OBJECTIVES Reading this article will familiarize the reader with (1) the unique chlamydial intracellular life cycle and the propensity for human chlamydial infections to become persistent and to result in immunopathologic (inflammatory) damage in target organs and (2) current evidence linking Chlamydia pneumoniae (Cpn) infection to obstructive lung diseases (asthma and chronic obstructive pulmonary disease, COPD). Potential therapeutic implications of the Cpn-asthma association are also discussed. DATA SOURCES All Medline articles (January 1985 to March 1999) that cross-referenced the exploded MESH headings "lung diseases, obstructive" and "Chlamydia pneumoniae" (N = 76). Additional referenced articles, published abstracts, book chapters, and conference proceedings were also utilized. STUDY SELECTION (1) Case reports and case series that identified Cpn infection in asthma and/or COPD and (2) epidemiologic studies of markers for Cpn infection in asthma and/or COPD that included one or more control groups. RESULTS Of 18 controlled epidemiologic studies (over 4000 cases/controls), 15 found significant associations between Cpn infection and asthma using organism detection (polymerase chain reaction (PCR) testing (n = 2 studies) or fluorescent antigen testing (n = 1)), Cpn-specific secretory IgA (sIgA) antibody testing (n = 1), and/or specific serum IgE (n = 2), IgA (n = 4), IgG (n = 3) or other antibody criteria (n = 7). Eight case reports and 13 case series of Cpn infection in asthma (over 100 patients) also include descriptions of improvement or complete disappearance of asthma symptoms after prolonged antibiotic therapy directed against Cpn. Significant associations with COPD (over 1000 cases/controls) were reported in 5 of 6 studies. Results of treating chronic chlamydial infections in COPD patients have not been reported. CONCLUSIONS Although the full clinical significance of these Cpn-obstructive lung disease associations remains to be established, reports of asthma improvement after treatment of Cpn infection deserve further investigation. Clinicians who manage asthma should be aware of this information since it may help to manage difficult cases. The hypothesis that Cpn infection in COPD can amplify smoking-associated inflammation and worsen fixed obstruction also deserves further study.
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MESH Headings
- Acute Disease
- Adolescent
- Adult
- Animals
- Antibodies, Bacterial/blood
- Asthma/epidemiology
- Asthma/etiology
- Biomarkers
- Case-Control Studies
- Cell Movement
- Child
- Chlamydia Infections/complications
- Chlamydia Infections/diagnosis
- Chlamydia Infections/drug therapy
- Chlamydia Infections/epidemiology
- Chlamydia Infections/immunology
- Chlamydia Infections/physiopathology
- Chlamydophila pneumoniae/immunology
- Chlamydophila pneumoniae/isolation & purification
- Chlamydophila pneumoniae/physiology
- Chronic Disease
- Comorbidity
- DNA, Bacterial/isolation & purification
- Disease Progression
- Humans
- Lung Diseases, Obstructive/epidemiology
- Lung Diseases, Obstructive/etiology
- Macrophages, Alveolar/cytology
- Macrophages, Alveolar/microbiology
- Mice
- Pneumonia, Bacterial/complications
- Pneumonia, Bacterial/diagnosis
- Pneumonia, Bacterial/drug therapy
- Pneumonia, Bacterial/microbiology
- Pneumonia, Bacterial/physiopathology
- Respiratory Tract Infections/complications
- Respiratory Tract Infections/epidemiology
- Respiratory Tract Infections/microbiology
- Respiratory Tract Infections/virology
- Serologic Tests
- Virus Diseases/complications
- Virus Diseases/epidemiology
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Affiliation(s)
- D L Hahn
- Dean Medical Center, Madison, Wisconsin 53704, USA
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18
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Von Hertzen L, Töyrylä M, Gimishanov A, Bloigu A, Leinonen M, Saikku P, Haahtela T. Asthma, atopy and Chlamydia pneumoniae antibodies in adults. Clin Exp Allergy 1999; 29:522-8. [PMID: 10202367 DOI: 10.1046/j.1365-2222.1999.00504.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Factors involved in the development of inflammation and asthma in nonatopic subjects have remained largely obscure, although there is some evidence to suggest that certain infections may play a role. OBJECTIVE We investigated the association between serological evidence of Chlamydia pneumoniae infection and asthma in adults, and the possible modifying effect of the patients' atopic status on this association. METHODS Four hundred and thirty consecutive patients who attended the hospital between 1992 and 1993 with symptoms suggestive of asthma, rhinitis or allergy were enrolled. Diagnostic procedures including lung function measurements and skin-prick tests were performed in all patients. The patients with established asthma (n = 332) were divided into those with recent asthma (n = 224, onset 1985 onward) and longstanding asthma (n = 108, onset before 1985). The controls (n = 98) comprised all subjects who did not meet the criteria of asthma. Serum immunoglobulin (Ig)G, IgA and IgM antibodies to C. pneumoniae were measured by the microimmunofluorescence test. RESULTS In women, the prevalences of elevated IgG (a titre of >/= 128) and IgA (>/= 32) antibody levels and the age-adjusted geometric mean titres (GMT) of IgG and IgA antibodies were invariably highest among subjects with nonatopic longstanding asthma. Elevated IgG titres in women occurred in 11% of controls, in 28% of nonatopic recent onset asthmatics, and in 43% of asthmatics with nonatopic longstanding disease; for men the respective figures were 33, 50 and 64%. Logistic regression analysis controlling for age, sex and smoking showed that asthma was significantly associated with elevated IgG antibody levels to C. pneumoniae (odds ratio 3.3, 1.6-6.8 for longstanding asthma, 2.3, 1. 2-4.4 for recent asthma, and among women only 4.2, 1.6-10.9 for longstanding asthma, and 3.0, 1.3-7.2 for recent asthma). When the atopics and nonatopics were analysed separately, an even stronger relationship in the nonatopics was obtained for longstanding asthma (6.0,2.1-17.1). In contrast, the relationship between atopic asthma, either recent or longstanding, and elevated IgG titres was not significant, indicating that asthma per se does not predispose to C. pneumoniae infection. CONCLUSIONS Asthma was significantly associated with elevated IgG antibody levels to C. pneumoniae, and this association was strongest for nonatopic longstanding asthma.
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19
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Airenne S, Surcel HM, Alakärppä H, Laitinen K, Paavonen J, Saikku P, Laurila A. Chlamydia pneumoniae infection in human monocytes. Infect Immun 1999; 67:1445-9. [PMID: 10024593 PMCID: PMC96479 DOI: 10.1128/iai.67.3.1445-1449.1999] [Citation(s) in RCA: 91] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Chlamydia pneumoniae infection has been associated with cardiovascular diseases in seroepidemiological studies and by demonstration of the pathogen in atherosclerotic lesions. It has the capacity to infect several cell types, including monocyte-derived macrophages, which play an essential role in the development of atherosclerosis. However, the persistence of C. pneumoniae in mononuclear cells is poorly understood. To study the morphology and biological characteristics of the infection, human peripheral blood monocytes were infected with C. pneumoniae. Freshly isolated monocytes resisted the development of infectious progeny, and confocal and transmission electron microscopy showed that the morphology of the inclusions and chlamydial particles was abnormal. Addition of tryptophan or antibodies against gamma interferon did not diminish the inhibition of C. pneumoniae, suggesting that other factors are involved in the chlamydiostatic activity of the monocytes. Chlamydial mRNA was expressed at least 3 days after infection, however, and a capability for infected monocytes to induce a positive lymphocyte proliferative response was detected for up to 7 days, indicating that C. pneumoniae remains metabolically active in the monocytes in vitro. These results are in accordance with the hypothesis that C. pneumoniae may participate in the maintenance of local immunological response and inflammation via infected monocytes and thus enhance atherosclerosis.
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Affiliation(s)
- S Airenne
- National Public Health Institute, Oulu, Helsinki, Finland
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20
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ALAKÄRPPÄ HANNU, SURCEL HELJÄMARJA, LAITINEN KIRSI, JUVONEN TATU, SAIKKU PEKKA, LAURILA AINO. Detection ofChlamydia pneumoniaeby colorimetric in situ hybridization. APMIS 1999. [DOI: 10.1111/j.1699-0463.1999.tb01580.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Miyashita N, Niki Y, Nakajima M, Kawane H, Matsushima T. Chlamydia pneumoniae infection in patients with diffuse panbronchiolitis and COPD. Chest 1998; 114:969-71. [PMID: 9792563 DOI: 10.1378/chest.114.4.969] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
STUDY OBJECTIVES To determine the possible association of Chlamydia pneumoniae infection with diffuse panbronchiolitis (DPB) and with COPD. DESIGN Prospective case-control study. SETTING Division of Respiratory Diseases, Kawasaki Medical School Hospital. PARTICIPANTS Fifteen DPB and 77 COPD patients who had acute exacerbations of respiratory conditions and 35 and 120 control subjects, respectively, matched for age, sex, and smoking status. MEASUREMENTS AND RESULTS Nasopharyngeal swabs and paired serum samples were obtained from all patients and control subjects for isolation and antibody testing of C pneumoniae. C pneumoniae was isolated from one DPB patient and from no COPD patients or control subjects. Serologic evidence of acute C pneumoniae infection was observed in one DPB patient (6.7%) and six COPD patients (7.8%). The prevalence and mean titer of C pneumoniae IgG and IgA antibodies were significantly higher in COPD patients than in control subjects (p<0.001). However, no such differences were observed between DPB patients and control subjects. CONCLUSIONS This study showed that C pneumoniae infection may be associated with acute exacerbations of COPD and that chronic C pneumoniae infection is common in COPD but not in DPB.
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Affiliation(s)
- N Miyashita
- Department of Medicine, Kawasaki Medical School, Kurashiki City, Okayama, Japan
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22
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Falck G, Engstrand I, Gad A, Gnarpe J, Gnarpe H, Laurila A. Demonstration of Chlamydia pneumoniae in patients with chronic pharyngitis. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1998; 29:585-9. [PMID: 9571739 DOI: 10.3109/00365549709035899] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
12 patients with longstanding throat symptoms, who were also positive by PCR (polymerase chain reaction) for Chlamydia pneumoniae were selected for a longitudinal study to determine whether C. pneumoniae is an aetiological agent for chronic pharyngitis. Specimens for culture and PCR detection of C. pneumoniae were taken from the retropharyngeal wall and blood specimens were taken for serology. Biopsies were taken from the mucosal membrane of the retropharyngeal wall for histological and immunohistochemical studies. C. pneumoniae was cultured from 4 cases. 10 patients had specific humoral antibodies to C. pneumoniae and 9 had high and increasing specific antibody titres to C. pneumoniae suggesting ongoing infection. The organism was demonstrated in the tissue from the retropharyngeal mucosal membrane by immunohistochemistry in 9 patients. The findings suggest that C. pneumoniae may be an aetiological agent for chronic pharyngitis.
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Affiliation(s)
- G Falck
- Department of Family Medicine, University Hospital, Uppsala, Sweden
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23
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Miyashita N, Kubota Y, Nakajima M, Niki Y, Kawane H, Matsushima T. Chlamydia pneumoniae and exacerbations of asthma in adults. Ann Allergy Asthma Immunol 1998; 80:405-9. [PMID: 9609611 PMCID: PMC7128287 DOI: 10.1016/s1081-1206(10)62992-4] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chlamydia pneumoniae is a frequent causative agent of acute respiratory disease and has been recently reported as a possible cause of asthma. OBJECTIVE We assessed the prevalence of C. pneumoniae infections in adult patients with acute exacerbations of asthma. METHODS One hundred sixty-eight adult patients with acute exacerbations of asthma and 108 control subjects matched for age, sex, and smoking status were studied. Nasopharyngeal swab specimens were obtained from all subjects and analyzed by isolation in cell culture and polymerase chain reaction (PCR) test for C. pneumoniae. Serum samples were also obtained and tested for C. pneumoniae-specific antibodies by the microimmunofluorescence test. RESULTS C. pneumoniae was isolated from two (1.2%) asthma patients and none from controls and detected by PCR from nine (5.4%) cases and one (0.9%) control. Both culture positive specimens were also positive in PCR. Further, serologic evidence of acute C. pneumoniae infection was present in 15 (8.9%) of asthma patients and in three (2.8%) of controls (P = .048). The prevalence of C. pneumoniae-specific IgG and IgA was significantly higher in asthma cases than in controls (IgG > or = 1:16: 85.1% versus 67.6%, P = .001; IgA > or = 1:16: 47.6% versus 16.7%, P < .001). Mean titer of IgG and IgA was also significantly greater in asthma cases than in controls (IgG: 38.8 versus 18.1, P = .0001; IgA: 17.2 versus 6.1, P = .0001). CONCLUSIONS Our data suggest that C. pneumoniae infection may trigger acute exacerbations of adult asthma.
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Affiliation(s)
- N Miyashita
- Department of Medicine, Kawasaki Medical School, Kurashiki City, Okayama, Japan
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24
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Laurila A, Bloigu A, Näyhä S, Hassi J, Leinonen M, Saikku P. Chronic Chlamydia pneumoniae infection is associated with a serum lipid profile known to be a risk factor for atherosclerosis. Arterioscler Thromb Vasc Biol 1997; 17:2910-3. [PMID: 9409275 DOI: 10.1161/01.atv.17.11.2910] [Citation(s) in RCA: 93] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Chlamydia pneumoniae infection has been associated with coronary heart disease. To evaluate the mechanisms of this association, we studied whether chronic C. pneumoniae infection affects serum lipid values similarly to acute infections. Triglyceride, total and HDL cholesterol concentrations, and C. pneumoniae antibodies were measured from paired serum samples of 415 Finnish males taken 3 years apart. Chronic infection, defined as persistent IgG and IgA antibodies, was found in 20%, and the antibodies were negative (IgG < 32 and IgA < 16 in both samples) in 15% of the cases studied. The serum triglyceride and total cholesterol concentrations were higher in the subjects with a chronic C. pneumoniae infection than in the subjects with no antibodies (1.23 versus 1.03 mmol/L and 6.41 versus 6.31 mmol/L, respectively). The HDL cholesterol concentrations and the ratios of HDL cholesterol to total cholesterol were significantly decreased in the subjects with chronic infection (1.24 versus 1.36 mmol/L, P = .026; and 0.19 versus 0.22, P = .018, respectively). Chronic C. pneumoniae infection seems to be associated with a serum lipid profile considered to increase the risk of atherosclerosis. This finding supports the hypothesis that infections play a role in the pathogenesis of atherosclerosis.
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Affiliation(s)
- A Laurila
- National Public Health Institute, Oulu, Finland
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25
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Laitinen K, Laurila A, Pyhälä L, Leinonen M, Saikku P. Chlamydia pneumoniae infection induces inflammatory changes in the aortas of rabbits. Infect Immun 1997; 65:4832-5. [PMID: 9353072 PMCID: PMC175693 DOI: 10.1128/iai.65.11.4832-4835.1997] [Citation(s) in RCA: 164] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Chlamydia pneumoniae, a common human respiratory pathogen, has been associated with atherosclerosis in several seroepidemiological studies. Moreover, its presence in lesions of vessel walls has been demonstrated by culture, immunohistochemistry, PCR, and electron microscopy. In this study, we infected intranasally with C. pneumoniae New Zealand White rabbits which had been fed a normal diet. Reinfection was given 3 weeks later. Six of the nine reinfected animals showed inflammatory changes consisting of intimal thickening or fibroid plaques resembling atherosclerosis in 2 to 4 weeks after reinfection. One rabbit had calcified lesions. Immunohistochemistry for C. pneumoniae was strongly positive in the three older affected animals. No lesions were seen in the controls. The results suggest that C. pneumoniae infection is capable of inducing inflammatory atherosclerosis-like changes in the aortas of infected rabbits.
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Affiliation(s)
- K Laitinen
- National Public Health Institute, Helsinki, Finland
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26
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Juvonen J, Juvonen T, Laurila A, Alakärppä H, Lounatmaa K, Surcel HM, Leinonen M, Kairaluoma MI, Saikku P. Demonstration of Chlamydia pneumoniae in the walls of abdominal aortic aneurysms. J Vasc Surg 1997; 25:499-505. [PMID: 9081131 DOI: 10.1016/s0741-5214(97)70260-x] [Citation(s) in RCA: 126] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Seroepidemiologic studies have indicated an association between chronic Chlamydia pneumoniae infection and coronary heart disease. The organism, which is a common respiratory pathogen, has been demonstrated in atherosclerotic lesions of the aorta and coronary arteries. Abdominal aortic aneurysms are frequently associated with atherosclerosis, and inflammation may actually be an important factor in aneurysmal dilatation. Hence it could be assumed that C. pneumoniae may play a role in maintaining an inflammation and triggering the development of aortic aneurysms. METHODS AND RESULTS Specimens from abdominal aortic aneurysm were examined for the presence of C. pneumoniae by immunohistochemical analysis, the polymerase chain reaction amplifying omp 1 gene, transmission electron microscopy, and culture methods with histologically atherosclerosis-negative human aortic tissues used as a control group. Chlamydial lipopolysaccharide and C. pneumoniae specific antigens were found by immunohistochemistry in 12 and 8 of 12 aneurysm specimens, respectively, and C. pneumoniae DNA could be demonstrated in 6 of 6 aneurysm specimens studied. Furthermore electron microscopy revealed the presence of Chlamydia-like elementary bodies in three of four aneurysm specimens tested. None of the control samples gave positive reaction in the polymerase chain reaction, and C. pneumoniae antigens were not detected in any of them. CONCLUSIONS C. pneumoniae is frequently found in the vessel wall of abdominal aortic aneurysm. The potential etiopathogenetic role of C. pneumoniae in the development of these aneurysms remains to be studied.
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Affiliation(s)
- J Juvonen
- Department of Internal Medicine, Central Hospital of Kainuu, Kajaani
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27
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Laurila AL, Anttila T, Läärä E, Bloigu A, Virtamo J, Albanes D, Leinonen M, Saikku P. Serological evidence of an association between Chlamydia pneumoniae infection and lung cancer. Int J Cancer 1997; 74:31-4. [PMID: 9036866 DOI: 10.1002/(sici)1097-0215(19970220)74:1<31::aid-ijc6>3.0.co;2-1] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Epidemiological evidence suggests that airway obstruction is an independent risk factor for lung cancer and that this cannot be explained by active or passive smoking alone. Chlamydia pneumoniae infection has been associated with chronic bronchitis and its exacerbates. Our aim was to evaluate the association between chronic C. pneumoniae infection and risk of lung cancer among male smokers. Smoking males with lung cancer (n = 230) and their age- and locality-matched controls were selected among participants of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. The presence of C. pneumoniae infection was assessed by analyzing specific antibodies and immune complexes in 2 serum samples collected with a 3-year interval before the lung cancer diagnosis. The diagnosis of chronic infection was based on stable levels of positive specific IgA antibody (titer > or = 16) and immune complex (titer > or = 4). Relative risks were estimated by odds ratios (OR) adjusted for age, locality and smoking history by a conditional logistic regression model. Markers suggesting chronic C. pneumoniae infection were present in 52% of cases and 45% of controls and hence were positively associated with the incidence of lung cancer (OR 1.6; 95% confidence interval [CI] 1.0-2.3). The incidence was especially increased in men younger than 60 years (OR 2.9; 95% CI 1.5-5.4) but not in the older age group (OR 0.9; 95% CI 0.5-1.6). Before concluding that C. pneumoniae infection is a new independent risk factor for lung cancer, corroboration from other studies with larger number of cases and longer follow-up is needed.
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Affiliation(s)
- A L Laurila
- National Public Health Institute, Oulu, Finland
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28
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Hahn DL, Anttila T, Saikku P. Association of Chlamydia pneumoniae IgA antibodies with recently symptomatic asthma. Epidemiol Infect 1996; 117:513-7. [PMID: 8972677 PMCID: PMC2271656 DOI: 10.1017/s0950268800059197] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
To determine whether recently diagnosed adult-onset asthma is associated with serologic evidence of chronic Chlamydia pneumoniae infection, we performed a case-control study in a primary care clinic of cases with asthma (25 adults reporting first symptoms of asthma within 2 years of enrollment) and 45 concurrently enrolled sex and age (+/- 10 years) matched non-asthmatic controls with normal pulmonary function. C. pneumoniae-specific IgA, IgG and IgG4 antibodies, and circulating immune complexes (CIC) were measured by microimmunofluorescence testing. Results showed that frequencies of IgG titres > or = 16 (92%), IgG4 titres > or = 16 (20%) and CIC > or = 4 (60%) in asthma patients were not significantly different from those of controls. However, asthmatics had a significantly higher prevalence of C. pneumoniae-specific IgA titres > or = 10 (72% of cases vs 44% of controls, P < 0.05). After adjustment for the effects of age, sex and smoking, the odds ratio for an association of IgA and asthma was 3.7 (95% confidence interval 1.2-11.5). We conclude that recently symptomatic reversible airway obstruction in adults is associated with the presence of C. pneumoniae-specific IgA antibodies, a proposed indicator of chronic respiratory C. pneumoniae infection.
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Affiliation(s)
- D L Hahn
- Dean Medical Center, Madison, Wisconsin, USA
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29
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Laitinen K, Laurila AL, Leinonen M, Saikku P. Reactivation of Chlamydia pneumoniae infection in mice by cortisone treatment. Infect Immun 1996; 64:1488-90. [PMID: 8606126 PMCID: PMC173951 DOI: 10.1128/iai.64.4.1488-1490.1996] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Reactivation of Chlamydia pneumoniae infection was studied by inducing immunosuppression by cortisone acetate treatment given every other day for 14 days in intranasally infected NIH/s mice. The treatment started 2 or 4 weeks after primary infection, when no C. pneumoniae was detected. C. pneumoniae could be recovered from the lung cultures on days 7 and 9 in 10 and 60% of the mice, respectively, when cortisone treatment was begun 30 days after infection. These results confirm the persistent nature of C. pneumoniae infection.
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Affiliation(s)
- K Laitinen
- National Public Health Institute, Helsinki, Finland
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