title: Relation of C. pneumoniae antibodies to inflammation and atherosclerosclerosis in dialysis patients.
abstract: OBJECTIVE
  the aim of this study was to investigate the association between the presence of antibodies to C. pneumoniae, some markers of inflammation and the presence of preclinical atherosclerotic lesions in hemodyalisis (HD) patients treated with different dialytic membranes.
  
  
  METHODS
  C. pneumoniae antibodies were measured by microimmunofluorescence in blood samples of 68 chronic HD patients and in 120 healthy blood donors. Intima-media thickness (IMT) of carotid and of femoral arteries, eco-color doppler of sovraortic trunk and lower limb vessels were evaluated. Plasma levels of C-reactive protein (CRP) and terminal complement (C) complex, C5b-9, were measured.
  
  
  RESULTS
  HD patients treated by cellulosic membranes have significantly higher plasma levels of C5b-9 and of CRP compared to those treated by synthetic membranes. A significantly higher prevalence of IgG antibodies to C. pneumoniae and also at higher titre was observed in HD patients in comparison to the controls (66% vs. 28%). The carotid artery mean wall thickness was significantly lower in C. pneumoniae seronegative patients than C. pneumoniae seropositive patients. Similar results were obtained for limb arteries. The use of cellulosic membranes, but not synthetic membranes, was associated with higher carotid IMT and this was independent of the C. pneumoniae serology status.
  
  
  CONCLUSIONS
  in addition to known risk factors, the type of dialytic membrane used may contribute to the progression of atherosclerosis lesions in HD patients. Our data strengthen the evidences that C. pneumoniae infection under high inflammatory status might be a further risk factor for progression of atherosclerosis in HD patients, particularly in those treated with cellulosic membranes.
authors.affiliation: Department of Internal Medicine and Public Health, University of Bari, Bari, Italy. r.monno@igiene-seconda.uniba.it
authors.forename: R
authors.initials: R
authors.lastname: Monno
authors.forename: G
authors.initials: G
authors.lastname: Pertosa
authors.forename: G
authors.initials: G
authors.lastname: Grandaliano
authors.forename: L
authors.initials: L
authors.lastname: Fumarola
authors.forename: G
authors.initials: G
authors.lastname: Giannelli
authors.forename: S
authors.initials: S
authors.lastname: Simone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000276:immunology*; D002097:C-Reactive Protein / Q000032:analysis; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002482:Cellulose; D016009:Chi-Square Distribution; D016993:Chlamydophila pneumoniae / Q000276:immunology*; D015938:Complement Membrane Attack Complex / Q000032:analysis; D018618:Echocardiography, Doppler, Color; D004797:Enzyme-Linked Immunosorbent Assay; D004867:Equipment Design; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005455:Fluorescent Antibody Technique; D006801:Humans; D007249:Inflammation / Q000276:immunology*; D018836:Inflammation Mediators / Q000097:blood; D007558:Italy; D007676:Kidney Failure, Chronic / Q000276:immunology / Q000628:therapy*; D016015:Logistic Models; D008567:Membranes, Artificial; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry; D006435:Renal Dialysis / Q000009:adverse effects* / Q000295:instrumentation; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D015938:Complement Membrane Attack Complex; D018836:Inflammation Mediators; D008567:Membranes, Artificial; D002482:Cellulose; D002097:C-Reactive Protein