Association between Chlamydia pneumoniae infection and atherosclerosis of cervical or intracranial cerebral vessels in Thai patients

Chaisinanunkul, Napasri N.; Chatsuwan, Tanittha; Suwanwela, Nijasri C.

doi:10.5372/1905-7415.1000.522

Abstract

Background

Chlamydia pneumoniae infection is associated with coronary and carotid atherosclerosis. The prevalence of chlamydia infection varies from one country to another. Prevalence is related to socioeconomic status and sites of atherosclerosis differ between different ethnicities.

Objectives

To study the association between chlamydia infections and cervicocerebral atherosclerosis in Thai patients.

Methods

In this observational case-control study, patients with significant extracranial carotid artery or intracranial artery stenosis by ultrasound and magnetic resonance angiography (MRA) were studied and compared with an age- and sex-matched group of control participants without evidence of carotid stenosis by ultrasound. Antibodies to C. pneumoniae were studied by microimmunofluorescence. IgG titer ≥1:64 or IgA titer ≥ 1:16 were considered positive.

Results

We included 75 patient participants in the case group with evidence of significant carotid or intracranial stenosis and 75 control participants. IgA seropositivity for C. pneumoniae was found in 12 patients in the case group (16%) and 1 control participant (1.3%) (OR 14.1; P = 0.001). In the case group, 43 patients participants (57%) and 40 (53%) control participants were seropositive for C. pneumoniae IgG (OR 1.18; P = 0.62). Multivariate analysis revealed that IgA seropositivity was significantly associated with both cervical and intracranial cerebral atherosclerosis independent of other vascular risk factors.

Conclusions

C. pneumoniae IgA seropositivity is associated with cervicocerebral atherosclerosis in Thai patients. This association is independent of other vascular risk factors and is present in almost all subgroups including those with extracranial carotid, intracranial artery, and combined stenoses.

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