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. 1996 Nov;34(11):2766–2769. doi: 10.1128/jcm.34.11.2766-2769.1996

Detection of Chlamydia pneumoniae but not Helicobacter pylori in atherosclerotic plaques of aortic aneurysms.

F Blasi 1, F Denti 1, M Erba 1, R Cosentini 1, R Raccanelli 1, A Rinaldi 1, L Fagetti 1, G Esposito 1, U Ruberti 1, L Allegra 1
PMCID: PMC229401  PMID: 8897180

Abstract

Recent reports suggest an association between Chlamydia pneumoniae and Helicobacter pylori bacteria and atherosclerosis. We studied 51 patients (mean age, 68.3 years) who underwent abdominal aortic aneurysm surgery. For each patient we performed a microimmunofluorescence test for immunoglobulin G (IgG), IgA, and IgM antibodies to C. pneumoniae specific antigen (TW-183). Anti-H. pylori antibodies were determined by means of an EIA-G test. Each aortic aneurysm surgical specimen was sampled into multiple sections of 0.3 cm2 each and frozen at -20 degrees C. Two samples of each aneurysm were used for a nested PCR with two sets of C. pneumoniae and two sets of H. pylori specific primers. Specimens were treated with a solution containing 20 mM Tris-HCl, Tween 20-Nonidet P-40 (0.5% [vol/vol] each), and 100 micrograms of proteinase K per ml and incubated at 60 degrees C for 1 h and at 98 degrees C for 10 min. DNA was extracted twice with phenol-chloroform-isoamylic alcohol and precipitated with sodium acetate-ethanol by standard methods. Forty-one patients were seropositive for C. pneumoniae with past-infection patterns in 32 patients (16 < or = IgG < 512; 32 < or = IgA < 256) and high antibody titers in 9 patients (IgG > or = 512). In 26 of 51 patients, C. pneumoniae DNA was detected in aortic aneurysm plaque specimens. Of these patients, 23 had a serologic past-infection pattern, 2 had an acute reinfection pattern, and 1 was seronegative. Forty-seven of 51 patients were seropositive for H. pylori. In all cases PCR showed no evidence of H. pylori presence in plaque specimens. This study provides data on a possible C. pneumoniae involvement in the pathogenesis of aortic aneurysm and additional evidence for an association between this agent and atherosclerosis. Conversely, notwithstanding a high H. pylori seroprevalence observed, our results tend to rule out the possibility of a direct involvement of H. pylori in atherosclerosis.

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Selected References

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  1. Adam E., Melnick J. L., Probtsfield J. L., Petrie B. L., Burek J., Bailey K. R., McCollum C. H., DeBakey M. E. High levels of cytomegalovirus antibody in patients requiring vascular surgery for atherosclerosis. Lancet. 1987 Aug 8;2(8554):291–293. doi: 10.1016/s0140-6736(87)90888-9. [DOI] [PubMed] [Google Scholar]
  2. Beaty C. D., Grayston J. T., Wang S. P., Kuo C. C., Reto C. S., Martin T. R. Chlamydia pneumoniae, strain TWAR, infection in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1991 Dec;144(6):1408–1410. doi: 10.1164/ajrccm/144.6.1408. [DOI] [PubMed] [Google Scholar]
  3. Benditt E. P., Barrett T., McDougall J. K. Viruses in the etiology of atherosclerosis. Proc Natl Acad Sci U S A. 1983 Oct;80(20):6386–6389. doi: 10.1073/pnas.80.20.6386. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Black C. M., Fields P. I., Messmer T. O., Berdal B. P. Detection of Chlamydia pneumoniae in clinical specimens by polymerase chain reaction using nested primers. Eur J Clin Microbiol Infect Dis. 1994 Sep;13(9):752–756. doi: 10.1007/BF02276060. [DOI] [PubMed] [Google Scholar]
  5. Blasi F., Cosentini R., Denti F., Allegra L. Two family outbreaks of Chlamydia pneumoniae infection. Eur Respir J. 1994 Jan;7(1):102–104. doi: 10.1183/09031936.94.07010102. [DOI] [PubMed] [Google Scholar]
  6. Blasi F., Cosentini R., Schoeller M. C., Lupo A., Allegra L. Chlamydia pneumoniae seroprevalence in immunocompetent and immunocompromised populations in Milan. Thorax. 1993 Dec;48(12):1261–1263. doi: 10.1136/thx.48.12.1261. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Blasi F., Legnani D., Lombardo V. M., Negretto G. G., Magliano E., Pozzoli R., Chiodo F., Fasoli A., Allegra L. Chlamydia pneumoniae infection in acute exacerbations of COPD. Eur Respir J. 1993 Jan;6(1):19–22. [PubMed] [Google Scholar]
  8. Campbell L. A., Perez Melgosa M., Hamilton D. J., Kuo C. C., Grayston J. T. Detection of Chlamydia pneumoniae by polymerase chain reaction. J Clin Microbiol. 1992 Feb;30(2):434–439. doi: 10.1128/jcm.30.2.434-439.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Evander M., Edlund K., Bodén E., Gustafsson A., Jonsson M., Karlsson R., Rylander E., Wadell G. Comparison of a one-step and a two-step polymerase chain reaction with degenerate general primers in a population-based study of human papillomavirus infection in young Swedish women. J Clin Microbiol. 1992 Apr;30(4):987–992. doi: 10.1128/jcm.30.4.987-992.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Gaydos C. A., Quinn T. C., Eiden J. J. Identification of Chlamydia pneumoniae by DNA amplification of the 16S rRNA gene. J Clin Microbiol. 1992 Apr;30(4):796–800. doi: 10.1128/jcm.30.4.796-800.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hahn D. L., Dodge R. W., Golubjatnikov R. Association of Chlamydia pneumoniae (strain TWAR) infection with wheezing, asthmatic bronchitis, and adult-onset asthma. JAMA. 1991 Jul 10;266(2):225–230. [PubMed] [Google Scholar]
  12. Kleemola M., Saikku P., Visakorpi R., Wang S. P., Grayston J. T. Epidemics of pneumonia caused by TWAR, a new Chlamydia organism, in military trainees in Finland. J Infect Dis. 1988 Feb;157(2):230–236. doi: 10.1093/infdis/157.2.230. [DOI] [PubMed] [Google Scholar]
  13. Kuo C. C., Shor A., Campbell L. A., Fukushi H., Patton D. L., Grayston J. T. Demonstration of Chlamydia pneumoniae in atherosclerotic lesions of coronary arteries. J Infect Dis. 1993 Apr;167(4):841–849. doi: 10.1093/infdis/167.4.841. [DOI] [PubMed] [Google Scholar]
  14. Leinonen M., Linnanmäki E., Mattila K., Nieminen M. S., Valtonen V., Leirisalo-Repo M., Saikku P. Circulating immune complexes containing chlamydial lipopolysaccharide in acute myocardial infarction. Microb Pathog. 1990 Jul;9(1):67–73. doi: 10.1016/0882-4010(90)90042-o. [DOI] [PubMed] [Google Scholar]
  15. Marrie T. J. Chlamydia pneumoniae. Thorax. 1993 Jan;48(1):1–4. doi: 10.1136/thx.48.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Marrie T. J., Grayston J. T., Wang S. P., Kuo C. C. Pneumonia associated with the TWAR strain of Chlamydia. Ann Intern Med. 1987 Apr;106(4):507–511. doi: 10.7326/0003-4819-106-4-507. [DOI] [PubMed] [Google Scholar]
  17. Mattila K. J. Dental infections as a risk factor for acute myocardial infarction. Eur Heart J. 1993 Dec;14 (Suppl K):51–53. [PubMed] [Google Scholar]
  18. Melnick S. L., Shahar E., Folsom A. R., Grayston J. T., Sorlie P. D., Wang S. P., Szklo M. Past infection by Chlamydia pneumoniae strain TWAR and asymptomatic carotid atherosclerosis. Atherosclerosis Risk in Communities (ARIC) Study Investigators. Am J Med. 1993 Nov;95(5):499–504. doi: 10.1016/0002-9343(93)90332-j. [DOI] [PubMed] [Google Scholar]
  19. Mendall M. A., Goggin P. M., Molineaux N., Levy J., Toosy T., Strachan D., Camm A. J., Northfield T. C. Relation of Helicobacter pylori infection and coronary heart disease. Br Heart J. 1994 May;71(5):437–439. doi: 10.1136/hrt.71.5.437. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Nieminen M. S., Mattila K., Valtonen V. Infection and inflammation as risk factors for myocardial infarction. Eur Heart J. 1993 Dec;14 (Suppl K):12–16. [PubMed] [Google Scholar]
  21. Nikoskelainen J., Kalliomäki J. L., Lapinleimu K., Stenvik M., Halonen P. E. Coxsackie B virus antibodies in myocardial infarction. Acta Med Scand. 1983;214(1):29–32. doi: 10.1111/j.0954-6820.1983.tb08566.x. [DOI] [PubMed] [Google Scholar]
  22. Patel P., Carrington D., Strachan D. P., Leatham E., Goggin P., Northfield T. C., Mendall M. A. Fibrinogen: a link between chronic infection and coronary heart disease. Lancet. 1994 Jun 25;343(8913):1634–1635. doi: 10.1016/s0140-6736(94)93084-8. [DOI] [PubMed] [Google Scholar]
  23. Pesonen E., Siitonen O. Acute myocardial infarction precipitated by infectious disease. Am Heart J. 1981 Apr;101(4):512–513. doi: 10.1016/0002-8703(81)90150-2. [DOI] [PubMed] [Google Scholar]
  24. Saikku P. Chlamydia pneumoniae infection as a risk factor in acute myocardial infarction. Eur Heart J. 1993 Dec;14 (Suppl K):62–65. [PubMed] [Google Scholar]
  25. Saikku P., Leinonen M., Mattila K., Ekman M. R., Nieminen M. S., Mäkelä P. H., Huttunen J. K., Valtonen V. Serological evidence of an association of a novel Chlamydia, TWAR, with chronic coronary heart disease and acute myocardial infarction. Lancet. 1988 Oct 29;2(8618):983–986. doi: 10.1016/s0140-6736(88)90741-6. [DOI] [PubMed] [Google Scholar]
  26. Saikku P., Leinonen M., Tenkanen L., Linnanmäki E., Ekman M. R., Manninen V., Mänttäri M., Frick M. H., Huttunen J. K. Chronic Chlamydia pneumoniae infection as a risk factor for coronary heart disease in the Helsinki Heart Study. Ann Intern Med. 1992 Feb 15;116(4):273–278. doi: 10.7326/0003-4819-116-4-273. [DOI] [PubMed] [Google Scholar]
  27. Saikku P. The epidemiology and significance of Chlamydia pneumoniae. J Infect. 1992 Jul;25 (Suppl 1):27–34. doi: 10.1016/0163-4453(92)91913-v. [DOI] [PubMed] [Google Scholar]
  28. Shor A., Kuo C. C., Patton D. L. Detection of Chlamydia pneumoniae in coronary arterial fatty streaks and atheromatous plaques. S Afr Med J. 1992 Sep;82(3):158–161. [PubMed] [Google Scholar]
  29. Spodick D. H., Flessas A. P., Johnson M. M. Association of acute respiratory symptoms with onset of acute myocardial infarction: prospective investigation of 150 consecutive patients and matched control patients. Am J Cardiol. 1984 Feb 1;53(4):481–482. doi: 10.1016/0002-9149(84)90016-x. [DOI] [PubMed] [Google Scholar]
  30. Thom D. H., Grayston J. T., Siscovick D. S., Wang S. P., Weiss N. S., Daling J. R. Association of prior infection with Chlamydia pneumoniae and angiographically demonstrated coronary artery disease. JAMA. 1992 Jul 1;268(1):68–72. [PubMed] [Google Scholar]
  31. Thom D. H., Grayston J. T., Wang S. P., Kuo C. C., Altman J. Chlamydia pneumoniae strain TWAR, Mycoplasma pneumoniae, and viral infections in acute respiratory disease in a university student health clinic population. Am J Epidemiol. 1990 Aug;132(2):248–256. doi: 10.1093/oxfordjournals.aje.a115654. [DOI] [PubMed] [Google Scholar]
  32. Visser M. R., Vercellotti G. M. Herpes simplex virus and atherosclerosis. Eur Heart J. 1993 Dec;14 (Suppl K):39–42. [PubMed] [Google Scholar]
  33. Wang J. T., Lin J. T., Sheu J. C., Yang J. C., Chen D. S., Wang T. H. Detection of Helicobacter pylori in gastric biopsy tissue by polymerase chain reaction. Eur J Clin Microbiol Infect Dis. 1993 May;12(5):367–371. doi: 10.1007/BF01964436. [DOI] [PubMed] [Google Scholar]
  34. Wang S. P., Grayston J. T. Immunologic relationship between genital TRIC, lymphogranuloma venereum, and related organisms in a new microtiter indirect immunofluorescence test. Am J Ophthalmol. 1970 Sep;70(3):367–374. doi: 10.1016/0002-9394(70)90096-6. [DOI] [PubMed] [Google Scholar]
  35. White T. J., Madej R., Persing D. H. The polymerase chain reaction: clinical applications. Adv Clin Chem. 1992;29:161–196. doi: 10.1016/s0065-2423(08)60224-3. [DOI] [PubMed] [Google Scholar]

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