Chronic Chlamydia pneumoniae infection increases the risk of occlusion of lumbar segmental arteries of patients with sciatica: a 3-year follow-up study.
METHODS
A magnetic resonance imaging follow-up study of lumbar arteries among patients with sciatica with chronic Chlamydia pneumoniae infection.


OBJECTIVE
To determine whether chronic infection causes occlusion of lumbar arteries.


BACKGROUND
C. pneumoniae infection is associated with coronary heart disease, and the infectious pathogen has also been detected in abdominal aortic aneurysms and in atherosclerotic plaques. No studies are available on the effect of this infectious agent on lumbar arteries.


METHODS
Chronic infection was defined as persistent high positive immunoglobulin G and/or immunoglobulin A antibodies and/or the presence of immune complexes. The lumbar arteries, evaluated with two-dimensional time-of-flight magnetic resonance angiography, were scored as normal, narrowed, or occluded. The differences in the segmental and whole lumbar spine (segments L1-L4) sum of arterial occlusion at baseline and at 3 years, and the incidence of new arterial stenosis were compared in patients with and without chronic infection using the Kolmogorov-Smirnov test.


RESULTS
Patients with chronic infection were more likely to be persistent smokers (P = 0.006), male (P = 0.04), and more obese (P = 0.02) compared to patients with normal antibody levels. They had significantly higher degree of arterial stenosis at L4 segment at baseline and at 3 years (P = 0.001 and 0.002, respectively), in the whole lumbar spine at baseline and at 3 years (P < 0.001 for both), and at L1 and L3 segments at 3 years (P = 0.013 for both). The incidence of new arterial stenosis was similar in both patient groups. Patients with chronic infection also had significantly higher grade of endplate degeneration at L4-L5 (P = 0.008).


CONCLUSIONS
The results of this study suggest that chronic C. pneumoniae infection may induce stenosis of lumbar arteries.
Karppinen
Jaro
J
Department of Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland. jaro.karppinen@ttl.fi
Mikkonen
Paula
P
Kurunlahti
Mauno
M
Tervonen
Osmo
O
Paldanius
Mika
M
Vasari
Pekka
P
Saikku
Pekka
P
Vanharanta
Heikki
H
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D000936:Antigen-Antibody Complex / Q000097:blood; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D016022:Case-Control Studies; D023521:Chlamydophila Infections / Q000453:epidemiology* / Q000503:physiopathology; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008161:Lumbosacral Region / Q000098:blood supply / Q000503:physiopathology; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012306:Risk; D018570:Risk Assessment; D012585:Sciatica / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology
D000907:Antibodies, Bacterial; D000936:Antigen-Antibody Complex