Implications of antibodies to heat-shock proteins in ischemic heart disease.
OBJECTIVE
Experimental studies illustrate that priming with infectious agents, like Chlamydia pneumoniae, is involved in plaque formation and progression based on molecular mimicry with host heat-shock proteins (HSP). We have here evaluated the hypothesis that C. pneumoniae contributes to atherosclerotic disease progression via anti-HSP antibodies.


METHODS
The blood circulation of 151 consecutive patients with ischemic heart disease was screened for antibodies against human and Chlamydia HSP60 and C. pneumoniae IgG. Antibody levels were associated with the angiographic extent of coronary atherosclerosis, with clinical symptoms of ischemic heart disease and with biochemical and functional endothelial dysfunction markers.


RESULTS
Positive serology to human (11%) or Chlamydia HSP60 (22%) was not associated with the presence and extent of atherosclerosis, neither was it related with endothelial dysfunction. Patients with acute myocardial infarction had significantly lower Chlamydia HSP60 antibody levels (median OD 0.12, range: 0.02-0.75) than patients with stable (median OD 0.22, range: 0.02-2.67) or unstable angina pectoris (median OD 0.24, range: 0-2.48) (p=0.032). Subjects with positive C. pneumoniae IgG serology (if measured at a titre of 1:128) showed reduced flow-mediated vasodilation (p=0.024), but vasodilation responses did not differ in single-, two- or three-vessel disease.


CONCLUSIONS
Overall, antibody responses to C. pneumoniae IgG, human or Chlamydia HSP60 are not associated with endothelial dysfunction and presence and severity of coronary artery disease, arguing against the suggestion that infection contributes to disease progression and supplying additional proof that C. pneumoniae is an unlikely major risk factor of coronary atherosclerosis.
Hoymans
Vicky Y
VY
Department of Cardiology, Antwerp University, Belgium. vicky.hoymans@uza.be
Bosmans
Johan M
JM
Van Herck
Paul L
PL
Ieven
Margareta M
MM
Vrints
Christiaan J
CJ
D000368:Aged; D000704:Analysis of Variance; D000907:Antibodies, Bacterial / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D018834:Chaperonin 60 / Q000276:immunology*; D016009:Chi-Square Distribution; D016993:Chlamydophila pneumoniae / Q000276:immunology*; D015331:Cohort Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000276:immunology / Q000503:physiopathology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000276:immunology* / Q000503:physiopathology; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
D000907:Antibodies, Bacterial; D015415:Biomarkers; D018834:Chaperonin 60