TY - JOUR
TI - Inflammation and Chlamydia pneumoniae infection correlate with the
severity of peripheral arterial disease
AU - Kaperonis, E. A.
AU - Liapis, C. D.
AU - Kakisis, J. D.
AU - Dimitroulis,
AU - D.
AU - Papavassiliou, V. G.
AU - Perrea, D.
AU - Kostakis, A. G.
JO - European Journal of Vascular and Endovascular Surgery
PY - 2006
VL - 31
TODO - 5
SP - 509-515
PB - W B SAUNDERS CO LTD
SN - 1078-5884, 1532-2165
TODO - 10.1016/j.ejvs.2005.11.022
TODO - inflammation; inflammatory markers; infection; C. pneumoniae;
atherosclerosis; peripheral arterial disease; claudication
TODO - Background: Our aim was to investigate the association of inflammation
and Chlamydia pneumoniae infection with the presence and severity of
peripheral arterial disease.
Methods: Twenty-eight patients Whose initial claudication distance (ICD)
in the traditional constant-load treadmill test was < 200 m, underwent
femoral endarterectomy as part of their interventional treatment (group
A). Group B consisted of 23 patients whose ICD was > 200 m and were put
on medication and a daily exercise program. The control group consisted
of 30 non-vascular patients of the Ophthalmology Department (group C).
We measured the levels of C-reactive protein, fibrinogen, vascular cell
adhesion molecule-1 and tumor necrosis factor-alpha, and the titers of
IgA and IgG antibodies against C. pneunioniae in the serum of all the
patients, Finally, the atheromas and vein segments of group A patients,
were immunohistochemically (IHC) examined for the presence of C.
pneumoniae.
Results: Peripheral arterial disease (PAD) patients, had significantly
higher CRP (p = 0.026) and anti-Cp TgA levels (p 0,001) when compared to
control subjects, after a multiple linear regression analysis. The odds
ratio for the prevalence of femoral atherosclerosis was 3.1.6 for IgA
seropositive patients (Cl 1.15-8.67). When comparing group A and group B
patients, CRP (p=0.003) and IgA (p=0.011), were significantly correlated
with severe PAD. Group A patients with positive immunohistochemical
examination of the plaque, had higher anti-Cp TgA levels (p=0.023) and
TNF-alpha values (p= 0.031), compared to the IHC negative patients. C.
pneumoniae was detected in 50% of the femoral atheromas, but in only
3.6% of the veins.
Conclusion: This study supports the hypothesis that inflammation (CRP)
and chronic C. pneumoniae infection (IgA seropositivity), have an
important role in lower limb atherosclerosis and correlate with the
severity of the disease.
ER -