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A prospective study of Chlamydia pneumoniae infection and risk of MS in two US cohorts.
Neurology 2004; 62(10):1799-803Neur

Abstract

BACKGROUND

Chlamydia pneumoniae (Cpn) has been proposed as a possible etiologic agent in multiple sclerosis (MS). However, previous studies were cross-sectional and could not assess whether Cpn infection preceded the onset of MS.

METHODS

The authors conducted a prospective nested case-control study among 3 million US Army personnel and 121,466 members of the Kaiser Permanente Medical Care Program (KPMCP) cohort. Serum samples collected prior to onset of MS symptoms were available for 83 MS cases in the Army and 46 in the KPMCP cohort. Two controls were matched to each case on age, sex, and date of blood collection. Microimmunofluorescence was used to measure serum immunoglobulin M (IgM) and immunoglobulin G (IgG) antibody titers to Cpn; IgG titers > or 1:16 were considered positive for past Cpn infection.

RESULTS

Seropositivity for Cpn was not significantly associated with risk of MS in either cohort (Army: OR = 1.0; 95% CI 0.6, 1.8; KPMCP: OR = 1.5; 95% CI 0.7, 3.1) or in the pooled analysis (OR = 1.2; 95% CI 0.8, 1.9). Serum levels of anti-Cpn IgG antibody were also not associated with an increased risk of MS in the Army (OR for a fourfold difference in antibody titers = 0.9; 95% CI 0.7, 1.2) or in the pooled analysis (OR = 1.2; 95% CI 0.9, 1.4), but a significant increase in risk was seen in the KPMCP cohort (OR = 1.7; 95% CI 1.2, 2.5). The difference between these results in the Army and the KPMCP cohort was significant (p = 0.01).

CONCLUSIONS

Neither Cpn seropositivity nor serum anti-Cpn IgG antibody titers predicted risk of developing MS. However, due to the heterogeneity of results between cohorts, we cannot exclude the possibility that infection with Cpn may modify the risk of MS.

Authors+Show Affiliations

Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15159481

Citation

Munger, K L., et al. "A Prospective Study of Chlamydia Pneumoniae Infection and Risk of MS in Two US Cohorts." Neurology, vol. 62, no. 10, 2004, pp. 1799-803.
Munger KL, DeLorenze GN, Levin LI, et al. A prospective study of Chlamydia pneumoniae infection and risk of MS in two US cohorts. Neurology. 2004;62(10):1799-803.
Munger, K. L., DeLorenze, G. N., Levin, L. I., Rubertone, M. V., Vogelman, J. H., Peck, C. A., ... Ascherio, A. (2004). A prospective study of Chlamydia pneumoniae infection and risk of MS in two US cohorts. Neurology, 62(10), pp. 1799-803.
Munger KL, et al. A Prospective Study of Chlamydia Pneumoniae Infection and Risk of MS in Two US Cohorts. Neurology. 2004 May 25;62(10):1799-803. PubMed PMID: 15159481.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study of Chlamydia pneumoniae infection and risk of MS in two US cohorts. AU - Munger,K L, AU - DeLorenze,G N, AU - Levin,L I, AU - Rubertone,M V, AU - Vogelman,J H, AU - Peck,C A, AU - Peeling,R W, AU - Orentreich,N, AU - Ascherio,A, PY - 2004/5/26/pubmed PY - 2004/10/27/medline PY - 2004/5/26/entrez SP - 1799 EP - 803 JF - Neurology JO - Neurology VL - 62 IS - 10 N2 - BACKGROUND: Chlamydia pneumoniae (Cpn) has been proposed as a possible etiologic agent in multiple sclerosis (MS). However, previous studies were cross-sectional and could not assess whether Cpn infection preceded the onset of MS. METHODS: The authors conducted a prospective nested case-control study among 3 million US Army personnel and 121,466 members of the Kaiser Permanente Medical Care Program (KPMCP) cohort. Serum samples collected prior to onset of MS symptoms were available for 83 MS cases in the Army and 46 in the KPMCP cohort. Two controls were matched to each case on age, sex, and date of blood collection. Microimmunofluorescence was used to measure serum immunoglobulin M (IgM) and immunoglobulin G (IgG) antibody titers to Cpn; IgG titers > or 1:16 were considered positive for past Cpn infection. RESULTS: Seropositivity for Cpn was not significantly associated with risk of MS in either cohort (Army: OR = 1.0; 95% CI 0.6, 1.8; KPMCP: OR = 1.5; 95% CI 0.7, 3.1) or in the pooled analysis (OR = 1.2; 95% CI 0.8, 1.9). Serum levels of anti-Cpn IgG antibody were also not associated with an increased risk of MS in the Army (OR for a fourfold difference in antibody titers = 0.9; 95% CI 0.7, 1.2) or in the pooled analysis (OR = 1.2; 95% CI 0.9, 1.4), but a significant increase in risk was seen in the KPMCP cohort (OR = 1.7; 95% CI 1.2, 2.5). The difference between these results in the Army and the KPMCP cohort was significant (p = 0.01). CONCLUSIONS: Neither Cpn seropositivity nor serum anti-Cpn IgG antibody titers predicted risk of developing MS. However, due to the heterogeneity of results between cohorts, we cannot exclude the possibility that infection with Cpn may modify the risk of MS. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/15159481/A_prospective_study_of_Chlamydia_pneumoniae_infection_and_risk_of_MS_in_two_US_cohorts_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=15159481 DB - PRIME DP - Unbound Medicine ER -