Vaskulárna medicína 2/2010

The importance of Chlamydophila pneumoniae and cytomegalovirus infection in development of carotid plaques

Objective. To determine anti-cytomegalovirus (CMV) and anti-Chlamydophila pneumoniae (CP) antibodies in comparison with inflammatory markers, to detect CP DNA and CMV DNA performed with polymerase chain reaction (PCR) in peripheral Leucocytes (Le) and in atherosclerotic carotid plaques in patients undergoing carotid endarterectomy. Methods. 38 patients undergoing carotid endarterectomy, 24 males and 14 females , mean age 67.6 roka (interval 43–86 years) . Control group of 68 people, 38 males and 30 females, mean age 40.4 years. The presence of IgG specific anti-CMV antibodies was detected by Platelia™ CMV IgG a IgM ELISA kit (Bio Rad.). As positive anti-CMV IgG serum was that contanining 1.2 IU/ml. Anti-CP IgA and IgG antibodies were detected by the SeroCP IgA and IgG ELISA kit (Savyon Diagnostics Ltd, Israel) with optical density 1.1 as a cut-off value. Detection of IL-6 was performed by a IL-6 ELISA kit (Imunotech, France) with a positive value 3 ng/L. CRP was detected by C-reactive Protein ELISA (Immundiagnostik, Germany) with a positive value 3 mg/L. All analyses were performed and calculated according to the manufacturer’s instructions. Detection of CP DNA and CMV DNA was performed with PCR in peripheral leukocytes and crushed carotid plaques. Results. In all measured aspects there was a significant difference between group of patients and a control group. We did not succeed, however, to prove a clear evidence of CP DNA in peripheral leukocytes in the patients group. We found also significant difference in anti-CMV IgG antibodies that was 100.0% in symptomatic group in comparison to 76.5% positivity in asymptomatic patients (p=0.03). However, this was not corresponding to finding of CMV DNA in peripheral leukocytes as detected by PCR. Despite of repeated attempts to treat the AS plaques and using the same method of DNA extraction as applied to venous blood, all the samples were found to be negative. For this reason, this part of our experiment we evaluate as unsuccessful. Conclusion. We succeeded to prove a clear significant evidence of CMV DNA in peripheral leukocytes of patients with carotid disease (65.7%) in comparison to control group (less than 3%) (p=0.001). This was associated with finding of significant positivity of inflammatory markes in peripheral blood. Significant positivity of IgG and IgA anti-CP antibodies (p=0.03 and p=0.007, respectively) in patients group did not correspond with a detection of CP DNA in peripheral leukocytes. This could be explained with possible crossed imunity to other Chlamydophila varieties or could support a theory of CP infection as an initiation of atherosclerotic process in younger age.

Keywords: Cytomegalovirus, Chlamydophila pneumoniae, carotic endarterectomy, inflammatory markers, anti-CP and anti-CMV antibodies