Chlamydia pneumoniae immunoreactivity in coronary artery plaques of patients with acute coronary syndromes and its relation with serology.
BACKGROUND
An association between Chlamydia pneumoniae (Cpn) infection and coronary artery disease has been reported and examined by different techniques. However, its immunoreactivity in coronary artery plaques of patients with acute coronary syndrome (ACS) and its relation with serology are less well defined.


METHODS
We divided 40 coronary plaque specimens from 40 patients who underwent thrombectomy or directional coronary atherectomy into an ACS group (n = 22) and a non-ACS group (n = 18). Cpn in specimens was detected immunohistochemically and compared quantitatively. Serum immunoglobulin (Ig)A and IgG antibodies to Cpn and high-sensitivity C-reactive protein (hs-CRP) were measured. The relation between serology and immunohistochemical analysis was also investigated.


RESULTS
Cpn immunopositive cells per square millimeter (Cpn+ cells/mm2) in the ACS group were significantly more numerous than in the non-ACS group (median 7.44 vs 1.50, P = .0018). Cpn IgA seropositivity rates and titers in the ACS group were significantly higher than those in the non-ACS group (86.3% vs 22.2%, P = .0002; median titer 1.403 vs 0.545, P = .003). There were no differences in IgG antibodies between the 2 groups. The hs-CRP values (in milligrams per liter) in ACS group were significantly higher than in non-ACS group (median 2.8 vs 1.2, P = .0019). Serum IgA titers in patients with at least 5 Cpn+ cells/mm2 in the specimens were significantly higher than in patients with fewer Cpn+ cells (median 1.52 vs 0.86, P = .026). There was no difference in serum hs-CRP values in patients with more Cpn+ cells but a trend to an increase.


CONCLUSIONS
Immunohistology frequently detected Cpn in coronary plaques; Cpn+ cells were more prevalent in plaques associated with ACS, and Cpn IgA but not IgG titers were increased with ACS and with high densities of Cpn+ cells within plaque.
Liu
Ruiqin
R
Division of Cardiovascular Medicine, Ohashi Hospital, Toho University School of Medicine, Tokyo, Japan.
Yamamoto
Masato
M
Moroi
Masao
M
Kubota
Tetsuya
T
Ono
Tsuyoshi
T
Funatsu
Atsushi
A
Komatsu
Hiroki
H
Tsuji
Takahiro
T
Hara
Hidehiko
H
Hara
Hisao
H
Nakamura
Masato
M
Hirai
Hironori
H
Yamaguchi
Tetsu
T
D000208:Acute Disease; D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000276:immunology*; D023521:Chlamydophila Infections / Q000097:blood / Q000276:immunology*; D016993:Chlamydophila pneumoniae / Q000276:immunology*; D003324:Coronary Artery Disease / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis* / Q000097:blood; D007074:Immunoglobulin G / Q000032:analysis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000276:immunology*; D012698:Serologic Tests; D013577:Syndrome
D007070:Immunoglobulin A; D007074:Immunoglobulin G