RESUMEN
OBJECTIVE: Atherosclerosis is pathologically similar to a chronic inflammatory response. Recent reports have suggested that Chlamydia pneumoniae (C. pneumoniae) and Helicobacter pylori (H. pylori) play a role in the pathogenesis of atherosclerosis but this relation has not been confirmed on an inflammatory background. METHODS: Twenty-nine consecutive patients admitted to Suleyman Demirel University Medical School Cardiovascular Surgery Department, Isparta, Turkey between May 2002 to June 2003 were included in the study and the presence of C. pneumoniae and H. pylori DNA in atherosclerotic plaques of 14 coronary endarterectomy specimens and 15 left internal mammarian artery (LIMA) specimens as control subjects were determined by polymerase chain reaction. Serologic evidence of infection and inflammatory markers were also determined in both groups. RESULTS: Two C. pneumoniae DNA cases from the plaque group (14.3%) and 4 H. pylori DNA cases; 3 from plaque (21.4%) and one from the LIMA groups (6.7%) were detected. The C-reactive protein (mg/L) were higher in DNA positive samples of C. pneumoniae (66.58) and H. pylori (21.93) compared to DNA negatives of C. pneumoniae (8.49) and H. pylori (10.98), similarly interleukin-6 (U/L) levels were higher in DNA positive samples of C. pneumoniae (42.25) and H. pylori (56.37) compared with DNA negatives of C. pneumoniae (17.52) and H. pylori (13.28), but the differences were not statistically significant. Apolipoprotein B levels were significantly higher in C. pneumoniae immunoglobulin M positive cases (0.844 g/L) compared with negatives (0.661 g/L) (p=0.004). CONCLUSION: Chronic infections modify the serum lipid profile in a way that increases the risk of atherosclerosis. The increased titers of inflammation markers in DNA positive patients support inflammation in atherosclerosis, however, the results should be reproduced in a larger cohort.
Asunto(s)
Chlamydophila pneumoniae/genética , Enfermedad de la Arteria Coronaria/metabolismo , Vasos Coronarios/metabolismo , ADN Bacteriano/metabolismo , Helicobacter pylori/genética , Anciano , Anticuerpos Antibacterianos/sangre , Apolipoproteínas B/sangre , Proteína C-Reactiva/metabolismo , Estudios de Casos y Controles , Chlamydophila pneumoniae/inmunología , Femenino , Helicobacter pylori/inmunología , Humanos , Interleucina-6/sangre , Masculino , Persona de Mediana EdadRESUMEN
To date, there has been no convincing evidence for an association between Chlamydia pneumoniae or Helicobacter pylori and ectasia. In this case-control study, we have investigated the association of H. pylori and C. pneumoniae seropositivity with ectasia, severe coronary atherosclerosis, and normal vessels, which were so classified by coronary angiography. We have also evaluated the influence of these infections on inflammatory markers such as high-sensitive C-reactive protein (hsCRP) and interleukin 6 (IL-6). Of the 796 patients undergoing coronary angiography for suspected ischemic heart disease, 244 patients were recruited. Of these, 91 had normal vessels, 88 had 3 or more obstructed vessels, and 65 had ectatic vessels without atherosclerosis. Eighty-seven atherosclerotic patients (98.9%) were positive for C. pneumoniae IgG, as were 64 ectatic patients (98.5%) and 76 controls (83.5%) (P < 0.001). Forty-two atherosclerotic patients (47.7%) were positive for C. pneumoniae IgM, as were 43 ectatic patients (66.2%) and 43 controls (47.3%) (P = 0.036). Seventy-two atherosclerotic patients (81.8%) were positive for H. pylori IgA, as were 26 ectatic patients (40.0%) and 44 controls (48.4%) (P < 0.001). High-sensitive CRP levels were significantly higher in ectatic patients (5.639 mg/L) than in controls (4.390 mg/L) (P = 0.032), and IL-6 levels were significantly higher in atherosclerotic patients (33.92 U/L) than in controls (14.01 U/L) (P < 0.001). Interleukin-6 levels were higher in H. pylori seropositive patients, and hsCRP levels were higher in C. pneumoniae seropositive patients, when compared with seronegatives. We suggest that, as in atherosclerosis, C. pneumoniae infection is related to ectasia, with raised CRP levels.
Asunto(s)
Infecciones por Chlamydophila/complicaciones , Chlamydophila pneumoniae , Enfermedad de la Arteria Coronaria/microbiología , Infecciones por Helicobacter/complicaciones , Helicobacter pylori , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , Infecciones por Chlamydophila/sangre , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad Coronaria/sangre , Enfermedad Coronaria/diagnóstico , Enfermedad Coronaria/microbiología , Dilatación Patológica , Femenino , Infecciones por Helicobacter/sangre , Humanos , Inflamación/sangre , Inflamación/microbiología , Interleucina-6/sangre , Masculino , Persona de Mediana Edad , Índice de Severidad de la EnfermedadAsunto(s)
Anticuerpos Antivirales/sangre , Inmunoglobulina G/sangre , Vitíligo/inmunología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , Niño , Femenino , Herpesvirus Humano 6/inmunología , Humanos , Inmunoglobulina G/inmunología , Masculino , Persona de Mediana Edad , Vitíligo/terapiaRESUMEN
OBJECTIVE: Results of many studies show that apolipoprotein B (apo B) is a better marker of risk of vascular disease than other lipid markers including LDL and HDL-cholesterol and triglycerides. We investigated the association between two infectious agents: C. pneumoniae and H. pylori, known to have an atherogenic effect, and apo B, to evaluate the effects of chronic infections on apo B levels. METHODS AND RESULTS: The study group consisted of 257 patients in whom diagnostic coronary angiography was performed. C. pneumoniae IgG and IgM and H. pylori IgG and IgA antibodies were measured by enzyme-linked immunosorbent assay and apo B levels were measured by the nephelometry method. Established risk factors of atherosclerosis were recorded. Of 257 patients recruited, 104 had normal vessels, 88 had 3 or more vessels obstructed and 65 had ectatic vessels without atherosclerosis. Mean apo B concentration was significantly higher in C. pneumoniae IgG and IgM positive healthy subjects compared with C. pneumoniae negatives (0.954 vs. 0.722 and 0.973 vs. 0.851, p < 0.001 and p = 0.007, respectively). Apo B levels were significantly higher in severe atherosclerotic patients (0.985 +/- 0.234 g/l) compared with control subjects (0.892 +/- 0.244 g/l) (p = 0.008), but the difference was not significant in ectatic subjects (0.946 +/- 0.272 g/l) when compared with controls (p = 0.18). Apo B levels were higher but not statistically significant in H. pylori antibody positive cases when compared with negatives. CONCLUSIONS: Apo B levels increased with C. pneumoniae infection. This finding supports the hypothesis that lipid profiles change to atherogenic lipid profile in chronic infections.
Asunto(s)
Anticuerpos Antibacterianos/análisis , Apolipoproteínas B/análisis , Infecciones por Chlamydophila/epidemiología , Chlamydophila pneumoniae/inmunología , Enfermedad de la Arteria Coronaria/epidemiología , Helicobacter pylori/inmunología , Distribución por Edad , Biomarcadores/análisis , Estudios de Casos y Controles , Infecciones por Chlamydophila/diagnóstico , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/microbiología , Ensayo de Inmunoadsorción Enzimática , Femenino , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/epidemiología , Humanos , Inmunoglobulina A/análisis , Inmunoglobulina M/análisis , Incidencia , Modelos Lineales , Modelos Logísticos , Masculino , Análisis Multivariante , Probabilidad , Valores de Referencia , Medición de Riesgo , Índice de Severidad de la Enfermedad , Distribución por Sexo , Tasa de Supervivencia , Turquía/epidemiologíaRESUMEN
OBJECTIVE: The causative relation between Helicobacter pylori (H. pylori) and atherosclerosis has been determined as seropositivity or determination of H. pylori from atherome plaques by molecular methods. The site of entrance and the reservoir of the bacteria in the body is still a subject of discussion. In this study Helicobacter pylori stool antigen (HpSA) which shows gastrointestinal system colonization and infection with high specificity and sensitivity was determined in atherosclerotic, ectatic and angiographically normal groups. METHODS AND RESULTS: A total of 62 patients was categorized according to diagnostic coronary angiography as 12 had normal coronary arteries, eight had one, 18 had two, and 12 had three atherosclerotic coronary arteries. Twelve patients had ectatic vessels. There were 27 (44%) HpSA positive and 35 (56%) HpSA negative patients. There was a statistically significant relation between HpSA positivity and the degree of vessel involvement in coronary artery disease (CAD) patients, essentially between the group with three vessels (83%) obstructed and the normal group (25%). Ectatic vessel group had a higher incidence (50%) of HpSA positivity compared to the control group but not enough for statistical significance. CONCLUSIONS: The results indicate that gastrointestinal system H. pylori colonization increases the risk of atherosclerosis. We may speculate that the reservoir and spread of H. pylori is via gastrointestinal tract. Studies may be performed to detect whether gastrointestinal tract H. pylori infection treatment will decrease the risk of coronary artery damage caused by H. pylori.
Asunto(s)
Antígenos Bacterianos/análisis , Arteriosclerosis/microbiología , Infecciones por Helicobacter/complicaciones , Helicobacter pylori/inmunología , Arteriosclerosis/inmunología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
Rothia dentocariosa is one of the human oral flora members, and classified in the group of coryneform bacteria which are taxonomically heterogeneous. Although R. dentocariosa is considered as a contaminant in throat cultures generally, it may be the causative infectious agent in the presence of predisposing factors. The catalase activity which is used as a simple and initial identification test, becomes contradictory because of the detection of the catalase negative strains recently. The aim of this study was to compare several biochemical and enzymatic reactions for the identification of catalase positive and negative R. dentocariosa strains. A total of 42 R. dentocariosa strains which were isolated from throat cultures have been studied, and the positivity rate of mannose fermentation in catalase negative R. dentocariosa isolates was found to be significantly higher than those catalase positive (p < 0.05). In conclusion, mannose fermentation test seems to be a useful tool as an additional identification method of catalase negative R. dentocariosa isolates.