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Efecto sinérgico de la infección persistente por Chlamydia pneumoniae, la autoinmunidad y la inflamación en el riesgo
Tiina Huittinen1, Maija Leinonen, Leena Tenkanen
1National Public Health Institute, Aapistie 1, PO box 310, FIN-90101 Oulu, Finland. tiina.huittinen@ktl.fi
Circulation
|May 14, 2003
Resumen
Los anticuerpos persistentemente elevados contra Chlamydia pneumoniae y la proteína 60 de choque térmico humano, especialmente con alta proteína C-reactiva, aumentan significativamente el riesgo de eventos coronarios en hombres de mediana edad.
Área de la Ciencia:
- Investigación Cardiovascular Investigación Cardiovascular Investigación Cardiovascular Investigación Cardiovascular Investigación Cardiovascular
- Inmunología Inmunología.
- Enfermedad Infecciosa Enfermedad Infecciosa.
Sus antecedentes:
- La aterosclerosis está relacionada con las infecciones crónicas, la autoinmunidad y la inflamación.
- El impacto combinado de la infección por Chlamydia pneumoniae, los anticuerpos de la proteína de choque térmico humano 60 (hHsp60) y la proteína C reactiva (CRP) en el riesgo coronario requiere investigación.
Objetivo del estudio:
- Evaluar el efecto conjunto de la infección crónica por Chlamydia pneumoniae, los anticuerpos hHsp60 persistentemente elevados y la PCR en el riesgo coronario.
Principales métodos:
- Estudio prospectivo de casos y controles anidados dentro del Estudio del Corazón de Helsinki.
- Análisis de muestras de suero de 4081 hombres con dislipidemia para detectar anticuerpos de C. pneumoniae, anticuerpos de hHsp60 y niveles de PCR.
- Los eventos coronarios (infarto de miocardio no fatal o muerte coronaria) fueron seguidos durante 8,5 años.
Principales resultados:
- Los anticuerpos IgA persistentemente elevados contra C. pneumoniae o hHsp60 aumentan individualmente el riesgo de eventos coronarios (OR 1.96-2.11).
- El riesgo fue sustancialmente mayor cuando los anticuerpos elevados se combinaron con CRP elevado (OR 4.36-4.47).
- Los marcadores persistentemente elevados, no los transitorios, se asociaron con un mayor riesgo.
Conclusiones:
- Los anticuerpos C. pneumoniae y hHsp60 IgA persistentemente elevados predicen eventos coronarios.
- El valor predictivo se amplifica significativamente cuando estos anticuerpos están presentes junto con niveles elevados de PCR.
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