Related Experiment Videos
Chlamydia pneumoniae does not influence atherosclerotic plaque behavior in patients with established carotid artery
R G Gibbs1, M Sian, A W Mitchell
1Department of Vascular Surgery and Radiology, Imperial College School of Medicine, Charing Cross Campus, London, UK.
Insights
Chlamydia pneumoniae is common in carotid artery atherosclerosis plaques, but this study found no link between its presence and plaque instability or stroke risk. This challenges the rationale for antibiotic therapy in atherosclerosis.
Area of Science:
- Cardiovascular Research
- Infectious Disease Epidemiology
- Molecular Pathology
Background:
- Atherosclerosis is a complex disease with potential infectious etiologies.
- Chlamydia pneumoniae (C. pneumoniae) has been investigated as a potential contributor to atherosclerosis.
- The precise role of C. pneumoniae in disease development and clinical outcomes remains unclear.
Purpose of the Study:
- To investigate the association between C. pneumoniae infection and plaque instability in patients with advanced carotid artery atherosclerosis.
- To determine if C. pneumoniae presence correlates with clinical indicators of plaque instability, such as embolization and infarcts.
- To assess the impact of C. pneumoniae on disease progression and patient outcomes.
Main Methods:
- Detection of C. pneumoniae DNA using sensitive nested polymerase chain reaction (PCR).
- Assessment of plaque instability through recording preoperative embolization events via transcranial Doppler.
- Evaluation of cerebral infarcts using computed tomography (CT) scans.
Main Results:
- C. pneumoniae DNA was detected in 25.5% of 98 symptomatic patients with carotid atherosclerosis.
- No significant difference in embolization rates was observed between C. pneumoniae-positive and -negative patients.
- No correlation was found between C. pneumoniae status and the incidence of ipsilateral hemispheric infarcts.
Conclusions:
- C. pneumoniae is frequently found in atherosclerotic carotid artery plaques.
- The presence of C. pneumoniae does not appear to significantly impact plaque instability based on clinical markers.
- These findings question the effectiveness of antibiotic treatment for atherosclerosis.
Background And Purpose:
Research for infectious agents in the etiology of atherosclerosis has identified Chlamydia pneumoniae as a possible candidate. While there is evidence of an association between presence of this microorganism and atherosclerosis, it is unclear whether infection has a genuinely etiologic role in this disease, whether its presence influences clinical outcomes, and, if so, at which stages of disease this occurs. We have approached this issue in patients with advanced carotid artery atherosclerosis using molecular biological detection methods and clinically relevant indicators of pathology in carotid artery atheroma to determine whether the presence of C pneumoniae correlates with plaque instability.
Methods:
C pneumoniae was detected with the use of a sensitive nested polymerase chain reaction. Preoperative embolization and preoperative infarcts were recorded with the use of transcranial Doppler insonation of the middle cerebral artery and cerebral CT, respectively.
Results:
C pneumoniae DNA was detected in 25.5% of a cohort of 98 symptomatic patients. There was no significant difference in plaque stability as measured by embolization rates between the chlamydial-positive and -negative specimens. There was also no correlation between the number of ipsilateral hemispheric infarcts in the territory of the middle cerebral artery and chlamydial status.
Conclusions:
This study confirms that C pneumoniae is a common finding in atherosclerotic plaques of the carotid artery but suggests that the presence of the infectious organism has little detectable impact on plaque instability when measured by clinically significant markers. This raises important questions for the rationale of antibiotic therapy in atherosclerosis.