Acute Chlamydophila pneumoniae infection and its association with cardiovascular diseases.

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Guadalupe García Elorriaga Maricela Flores-Peralta Guillermo Del Rey-Pineda Maximino Miranda-García Eduardo César Lazcano-Ponce Eduardo Salazar-Martínez

Abstract

Chronic infection with Chlamydophila pneumoniae (C pneumoniae) has been associated with cardiovascular disease (CVD). This study evaluates the association of acute C pneumoniae infection and CVD in adult patients. We conducted a cross-sectional study that included 397 patients with a diagnosis of CVD, and 127 without CVD, at the Hospital General de Zona del Instituto Mexicano del Seguro Social (IMSS) in the state of Morelos, Mexico; the diagnosis was established by the Department of Cardiology. Patients with CVD were divided into 4 groups: I) Cardiac arrhythmia, II) Ischemic heart disease, III) Hypertensive heart disease and, IV) Valvular heart disease. Exposure to C pneumoniae was measured by antibody determination (IgG, IgM e IgA) with the microimmunofluorescence (MIF) technique. Statistical analysis included the determination of prevalence, and multiple logistic regression analysis. Results showed that the prevalence of acute C pneumoniae infection in the study population was 21%, and was highest in the groups with CVD versus patients without CVD, and an association was established (OR, 13.93; 95% CI, 3.8-66.1). Likewise, when comparing the Ig titer geometric means, we found that an acute C pneumoniae infection increased the risk of presenting a cardiac arrhythmia and ischemic heart disease by a factor of 18, and increased 12-fold the risk of having hypertensive or valvular heart disease. The prevalence of acute infection + chronic infection was greater in the group with ischemic heart disease (18.4%). Our study reflects the great significance of seroprevalence of acute infection with C pneumoniae among patients with CVD. Further, the seroprevalence of acute infection + chronic infection was greater in patients with ischemic heart disease, suggesting that this combination may be associated with the mechanisms leading to atherosclerosis mediating coronary episodes. It appears that this is the first report on the subject.

Keywords: Cardiovascular disease, Chlamydophila pneumoniae, Immunoglobulins, Microimmunofluorescence

Article Details

How to Cite
ELORRIAGA, Guadalupe García et al. Acute Chlamydophila pneumoniae infection and its association with cardiovascular diseases.. Medical Research Archives, [S.l.], v. 9, n. 8, aug. 2021. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2532>. Date accessed: 31 jan. 2023. doi: https://doi.org/10.18103/mra.v9i8.2532.
Section
Research Articles

References

1. Monsey L, Best LG, Zhu J, DeCroo S, Anderson MZ. The association of mannose binding lectin genotype and immune response to Chlamydia pneumoniae: The Strong Heart Study. PLoS One. 2019; 14:e0210640.doi: 10.1371/journal.pone.0210640 ID
2. Heron M, Anderson RN. Changes in the Leading Cause of Death: Recent Patterns in Heart Disease and Cancer Mortality. NCHS Data Brief. 2016; (254):1-8. PMID: 27598767
3. Maarman GJ, Chakafana G, Sliwa K. World Heart Day: a World Heart Federation communiqué on the future of basic sciences and translational medicine in global cardiovascular research. Am J Physiol Lung Cell Mol Physiol 2020; 319: L545–L546.doi:10.1152/ajplung.00339.2020
4. World Health Organization. Cardiovascular Diseases (Online). https://www.who.int/news-room/fact-sheets/detail/cardiovasculardiseases-(cvds) [22 July 2020].
5. México, principales causas de mortalidad 1938-2018. Recopilación: Ing. Manuel Aguirre Botello, con datos de INEGI, OMS y SINAIS. Actualización de Mayo 10 de 2020.
6. World Health Organization. Global regions. Cardiovascular Diseases (CVDs). Geneva, WHO (2017).
7. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM et al.
Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol. 2020; 22;76:2982-3021. doi: 10.1016/j.jacc.2020.11.010
8. Nazmi A, Diez-Roux AV, Jenny NS, Tsai MY, Szklo M, Aiello AE. The influence of persistent pathogens on circulating levels of inflammatory markers: a cross-sectional analysis from the Multi-Ethnic Study of Atherosclerosis. BMC Public Health. 2010; 10:706. doi: 10.1186/1471-2458-10-706
9. Kuo CC, Grayston JT, Campbell LA, Goo YA, Wissler RW, Benditt EP. Chlamydia pneumoniae (TWAR) in coronary arteries of young adults (15-34 years old). Proc Natl Acad Sci USA. 1995; 92:6911-6914.doi: 10.1073/pnas.92.15.6911


10. Bayram A, Erdogan MB, Eksi F, Yamak B. Demonstration of Chlamydophila pneumoniae, Mycoplasma pneumoniae, Cytomegalovirus, and Epstein-Barr virus in atherosclerotic coronary arteries, nonrheumatic calcific aortic and rheumatic stenotic mitral valves by polymerase chain reaction. Anadolu Kardiyol Derg. 2011; 11:237–43.doi: 10.5152/akd.2011.057
11. Khoshbayan A, Taheri F, Moghadam MT, Chegini Z, Shariati A. The association of Chlamydia pneumoniae infection with atherosclerosis: Review and update of in vitro and animal studies. Microb Pathog. 2021; 154:104803. doi: 10.1016/j.micpath.2021.104803.
12. Jama-Kmiecik A, Frej-Mądrzak M, Sarowska J, Choroszy-Król I. Selected aspects of Chlamydophila pneumoniae infections. Postepy Hig Med Dosw. 2015; 69: 612-623. doi: 10.5604/17322693.1152102
13. Noor R, Naz A, Maniha SM, Tabassum N, Tabassum T, Tabassum T et al. Microorganisms and cardiovascular diseases: importance of gut bacteria. Front Biosci (Landmark Ed). 2021; 26:22-28. doi: 10.52586/4921
14. Xue L, Liang YH, Gao YY, Wang XJ. Clinical study of Chlamydia pneumoniae infection in patients with coronary heart disease. BMC Cardiovasc Disord. 2019; 19:110.doi: 10.1186/s12872-019-1099-y
15. García-Elorriaga G., Calderón-Abbo M., González-Bonilla C.R. Asociación entre enfermedad cardiovascular y anticuerpos contra Chlamydia pneumoniae. Salud Pública Méx. 2002; 44:243-246. PMID: 12132322
16. García-Elorriaga G., Sánchez-Barriga J.J., Ramos-Corrales M.A., González-Bonilla C. Anticuerpos contra Chlamydophila en pacientes con infarto agudo del miocardio y riesgo coronario, y su relación con la muerte. Salud Pública Mex. 2005; 47:227-233. doi: 10.1590/s0036-36342005000300006
17. Wang SP, Kuo CC, Grayston JT. Formalinized Chlamydia trachomatis organisms as antigen in the micro-immunofluorescence test. J Clin Microbiol.1979; 10:259-261. doi: 10.1128/JCM.10.2.259-261.1979
18. Grayston JT. Infections caused by Chlamydia pneumoniae strain TWAR. Clin Infect Dis. 1992; 15:757-61. doi: 10.1093/clind/15.5.757.
19. Dowell SF, Peeling RW, Boman J, Carlone GM, Fields BS, Guarner J et al. Standardizing Chlamydia pneumoniae assays: recommendations from the Centers for Disease Control and Prevention (USA) and the Laboratory Centre for Disease Control (Canada). C. pneumoniae Workshop Participants. Clin Infect Dis. 2001; 33:492-503. doi: 10.1086/322632
20. Haider M, Rizvi M, Malik A, Azam M, Rabbani MU. Acute and chronic Chlamydia pneumoniae infection and inflammatory markers in coronary artery disease patients. J Infect Dev Ctries. 2011; 5:580-586.doi: 10.3855/jidc.1704
21. Campbell LA, Hahn D. Chlamydia pneumoniae Infections. In: Tan M, Hegemann JH, Sütterlin C. editors. Chlamydia Biology: From Genome to Disease. Caister Academic Press; 2020.p 31-58.
22. Tang RB, Dong JZ, Liu XP, Ma CS. Inflammation and atrial fibrillation: is Chlamydia pneumoniae a candidate pathogen of atrial fibrillation? Med Hypotheses. 2006; 67:462-466.doi: 10.1016/j.mehy.2006.03.017
23. Andrew P, Montenero AS. Is there a link between atrial fibrillation and certain bacterial infections? J Cardiovasc Med (Hagerstown). 2007; 8:990-996.doi: 10.2459/JCM.0b013e32801411e5.
24. Gupta S, Camm AJ. Chlamydia pneumoniae, antimicrobial therapy and coronary heart disease: a critical overview. Coron Artery Dis.1998; 9:339-43.doi: 10.1097/00019501-199809060-00004.
25. Ngeh J, Gupta S. Inflammation, infection and antimicrobial therapy in coronary heart disease – where do we currently stand? Fundam Clin Pharmacol. 2001; 15:85-93.doi: 10.1046/j.1472-8206.2001.00021.x
26. Blasi F, Fagetti L, Allegra L. Chlamydia pneumoniae detection in atherosclerotic plaques in Italy. J Infect Dis. 2000; 3, 444-446.doi: 10.1086/315621
27. Monno R, Fumarola L, Trerotoli P, Giannelli G, Correale M, Brunetti D et al. Seroprevalence of Chlamydophila pneumoniae in ischaemic heart disease. New Microbiol. 2010; 33:381-385.PMID: 21213597
28. Sessa R, Di Pietro M, Schiavoni G, Santino I, Cipriani P, Romano S et al. Prevalence of Chlamydia pneumoniae in peripheral blood mononuclear cells in Italian patients with acute ischaemic heart disease. Atherosclerosis. 2001; 159:521-525.doi: 10.1016/s0021-9150(01)00537-8
29. Mizooka M, Ishikawa S; JMS Cohort Study Group. Prevalence of Chlamydia pneumoniae in Japanese rural districts; association of smoking and physical activity with Chlamydia pneumoniae seropositivity. Intern Med. 2003; 42:960-966. doi:10.2169/internalmedicine.42.960
30. Koh WP, Taylor MB, Chew SK, Phoon MC, Kang KL, Chow VT. Chlamydia pneumoniae IgG seropositivity and clinical history of ischemic heart disease in Singapore. J Microbiol Immunol Infect. 2003; 36:169-74.PMID: 14582560
31. Agarwal A, Chander Y, Nagendra. Serological evidence of chronic Chlamydia pneumoniae Infection in Coronary Artery Disease. A Med J Armed Forces India. 2007; 63:229-32. doi: 10.1016/S0377-1237(07)80141-9.
32. Nyström-Rosander C, Lindh U, Ilbäck NG, Hjelm E, Thelin S, Lindqvist O et al. Interactions between Chlamydia pneumoniae and trace elements: a possible link to aortic valve sclerosis. Biol Trace Elem Res. 2003; 91:97-110.doi: 10.1385/bter:91:2:97
33. Turgeman Y, Levahar P, Lavi I, Shneor A, Colodner R, Samra Z et al. Adult calcific aortic stenosis and Chlamydia pneumoniae: the role of Chlamydia infection in valvular calcification. Isr Med Assoc J. 2006; 8:464-468. PMID: 16889160
34. Almeida NCC, Queiroz MAF, Lima SS, Costa IB, Fossa MAA, Vallinoto ACR et al. Association of Chlamydiatrachomatis, C. pneumoniae, and IL-6 and IL-8 gene alterations with heart diseases. Front Immunol. 2019; 10:87.doi: 10.3389/fimmu.2019.00087
35. Mizooka M, Ishikawa S; JMS Cohort Study Group. Prevalence of Chlamydia pneumoniae in Japanese rural districts; association of smoking and physical activity with Chlamydia pneumoniae seropositivity. Intern Med. 2003; 42:960-966. doi:10.2169/internalmedicine.42.960
36. Choroszy-Król I, Frej-Mądrzak M, Hober M, Sarowska J, Jama-Kmiecikl A. Infections Caused by Chlamydophila pneumoniae. Adv Clin Exp Med. 2014; 23: 123-126. doi: 10.17219/acem/37035

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