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Chlamydia pneumoniae accompanied by inflammation is associated with the progression of atherosclerosis in CAPD patients: a prospective study for 3 years.
Nephrol Dial Transplant 2008; 23(3):1011-8ND

Abstract

BACKGROUND

The causes of accelerated atherosclerosis in end-stage renal disease (ESRD) patients are unknown, although recent studies have suggested that Chlamydia pneumoniae (Cp) infection and inflammation might be contributing factors. We aimed to evaluate the association of carotid atherosclerosis progression with Cp infection and inflammation in patients undergoing peritoneal dialysis (PD).

METHODS

This is a prospective observational study. A total of 52 non-diabetic prevalent PD patients were included. The intima-media thickness of a common carotid artery (CCA-IMT) was measured at baseline and after 36 months by B-mode ultrasonography. Serum antibodies to Cp and inflammatory markers were obtained at the time of initial measurement of the CCA-IMT.

RESULTS

CCA-IMT progressors (deltaCCA-IMT > or = 0.015 mm/year) had a higher prevalence of seropositivity for Cp IgA antibody, a higher level of Cp IgA antibodies indices, log IL-(interleukin-)6, and intercellular adhesion molecule-1 (ICAM-1) compared to the non-progressors (deltaCCA-IMT < 0.015 mm/year). On multivariate analysis, Cp IgA index and log IL-6 were independent risk a factors for CCA-IMT progression. Also, Cp IgA index had independent positive correlation with the magnitude of annual deltaCCA-IMT. Cp IgA antibody seropositive patients showed significantly higher mean annual deltaCCA-IMT than seronegative patients. Moreover, patients with both positive Cp IgA antibodies and elevated IL-6 above the median level showed higher deltaCCA-IMT than those with either factor alone.

CONCLUSIONS

Our data showed that Cp and inflammation were significant risk factors of CCA-IMT change in PD patients. This study strengthens evidence that Cp is involved in the pathogenesis of atherosclerosis and also suggests that the effect of Cp infection under high inflammatory status might be a risk factor for progression of atherosclerosis.

Authors+Show Affiliations

Department of Internal Medicine, College of Medicine, Yonsei University, 134 Shinchon-dong, Seodaemoon-gu, Seoul, 120-752, Korea.No affiliation info availableNo 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)

Journal Article

Language

eng

PubMed ID

17940057

Citation

Kim, Dong Ki, et al. "Chlamydia Pneumoniae Accompanied By Inflammation Is Associated With the Progression of Atherosclerosis in CAPD Patients: a Prospective Study for 3 Years." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 23, no. 3, 2008, pp. 1011-8.
Kim DK, Kim HJ, Han SH, et al. Chlamydia pneumoniae accompanied by inflammation is associated with the progression of atherosclerosis in CAPD patients: a prospective study for 3 years. Nephrol Dial Transplant. 2008;23(3):1011-8.
Kim, D. K., Kim, H. J., Han, S. H., Lee, J. E., Moon, S. J., Kim, B. S., ... Han, D. S. (2008). Chlamydia pneumoniae accompanied by inflammation is associated with the progression of atherosclerosis in CAPD patients: a prospective study for 3 years. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 23(3), pp. 1011-8.
Kim DK, et al. Chlamydia Pneumoniae Accompanied By Inflammation Is Associated With the Progression of Atherosclerosis in CAPD Patients: a Prospective Study for 3 Years. Nephrol Dial Transplant. 2008;23(3):1011-8. PubMed PMID: 17940057.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chlamydia pneumoniae accompanied by inflammation is associated with the progression of atherosclerosis in CAPD patients: a prospective study for 3 years. AU - Kim,Dong Ki, AU - Kim,Hyun Jin, AU - Han,Seung Hyeok, AU - Lee,Jung Eun, AU - Moon,Sung Jin, AU - Kim,Beom Seok, AU - Kang,Shin-Wook, AU - Choi,Kyu Hun, AU - Lee,Ho Yung, AU - Han,Dae-Suk, Y1 - 2007/10/15/ PY - 2007/10/18/pubmed PY - 2008/4/24/medline PY - 2007/10/18/entrez SP - 1011 EP - 8 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol. Dial. Transplant. VL - 23 IS - 3 N2 - BACKGROUND: The causes of accelerated atherosclerosis in end-stage renal disease (ESRD) patients are unknown, although recent studies have suggested that Chlamydia pneumoniae (Cp) infection and inflammation might be contributing factors. We aimed to evaluate the association of carotid atherosclerosis progression with Cp infection and inflammation in patients undergoing peritoneal dialysis (PD). METHODS: This is a prospective observational study. A total of 52 non-diabetic prevalent PD patients were included. The intima-media thickness of a common carotid artery (CCA-IMT) was measured at baseline and after 36 months by B-mode ultrasonography. Serum antibodies to Cp and inflammatory markers were obtained at the time of initial measurement of the CCA-IMT. RESULTS: CCA-IMT progressors (deltaCCA-IMT > or = 0.015 mm/year) had a higher prevalence of seropositivity for Cp IgA antibody, a higher level of Cp IgA antibodies indices, log IL-(interleukin-)6, and intercellular adhesion molecule-1 (ICAM-1) compared to the non-progressors (deltaCCA-IMT < 0.015 mm/year). On multivariate analysis, Cp IgA index and log IL-6 were independent risk a factors for CCA-IMT progression. Also, Cp IgA index had independent positive correlation with the magnitude of annual deltaCCA-IMT. Cp IgA antibody seropositive patients showed significantly higher mean annual deltaCCA-IMT than seronegative patients. Moreover, patients with both positive Cp IgA antibodies and elevated IL-6 above the median level showed higher deltaCCA-IMT than those with either factor alone. CONCLUSIONS: Our data showed that Cp and inflammation were significant risk factors of CCA-IMT change in PD patients. This study strengthens evidence that Cp is involved in the pathogenesis of atherosclerosis and also suggests that the effect of Cp infection under high inflammatory status might be a risk factor for progression of atherosclerosis. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/17940057/Chlamydia_pneumoniae_accompanied_by_inflammation_is_associated_with_the_progression_of_atherosclerosis_in_CAPD_patients:_a_prospective_study_for_3_years_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfm696 DB - PRIME DP - Unbound Medicine ER -