Markers of Chlamydia pneumoniae and human cytomegalovirus infection in patients with chronic peripheral vascular disease and their relation to inflammation, endothelial dysfunction and changes in lipid metabolism

Abstract

Our aim was to detect markers of Chlamydia pneumoniae (CPN) and human cytomegalovirus (HCMV) infection in patients with peripheral vascular occlusive disease and to follow markers of inflammation, endothelial dysfunction and lipid metabolism alteration in patients with active infection. CPN genome was detected in 9 (47.4 %) patients by at least one PCR method. Serological markers of acute CPN infection were found in 5 (26.3 %) subjects; each of them showed also positivity in at least one of the PCR methods. HCMV DNA were detected in 2 (10.5 %) patients; HCMV-specific antibodies were detected in 14 (73.7 %) subjects, however only in IgG subclass. Subjects with HCMV PCR positivity thus showed no serological markers of active HCMV infection. Laboratory findings of acute CPN infection were associated with increased plasma levels of Lp(a), triacylglycerols, atherogenic index of plasma and E-selectin (p < 0.05). No significant differences were found in the other markers, including plasma levels of total cholesterol, ferritin, homocysteine, oxidized LDL, IL-6, IL-8, IL-18, TNF-alpha, soluble forms of VCAM-1 and ICAM-1, von Willebrand factor, C-reactive protein, and plasma nitrites & nitrates. Frequent presence of chlamydial DNA in atheromatous plaques from patients with peripheral vascular disease was confirmed. HCMV DNA was detected only sporadically and with positivity in anamnestic anti-HCMV antibodies (IgG) only, indicating a rare presence of latent virus rather than active replication. Patients with laboratory markers of acute CPN infection exhibited more pronounced alterations in lipid metabolism and endothelial dysfunction.

Pathogens and atherosclerosis: Update on the potential contribution of multiple infectious organisms to the pathogenesis of atherosclerosis

“…Over the past 20 years, there have been comparable numbers of reports of positive and negative associations with CVD morbidity, but a recent report has shown for the first time an association between CVD mortality and CMV antibody titres (85). There have been a large number of reports of the presence of CMV in human plaques (70,71,86,(87)(88)(89)(90)(91)(92)(93)(94)(95)(96)(97)(98)(99) as well as a number of failed attempts to document CMV in human lesions (100)(101)(102)(103)(104)(105)(106)(107). CMV has also been found in non-atherosclerotic blood vessels from cases and matched controls (86,91).…”

Is there an Association between Central Vein Stenosis and Line Infection in Patients with Tunnelled Central Venous Catheters (TCVCs)?

“…Similarly neointimal hyperplasia of arteriovenous fistulae is associated with pro-inflammatory states such as malnutrition and infection (19). Chlamydia pneumonia is associated with altered lipid metabolism, endothelial dysfunction and higher rates of peripheral vascular disease (20); HIV infection accelerates atherosclerosis and confers additional risk of myocardial infarction (18) and Cytomegalovirus infection is associated with a pro-inflammatory state leading to arteriovenous fistula failure (19). Alternatively, there may be two distinct genetic predisposition states for CVS and CRB.…”