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Absence of Chlamydia pneumoniae and Signs of Atherosclerotic Cardiovascular Disease in Adolescents with Systemic Lupus Erythematosus

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Abstract

Patients with systemic lupus erythematosus (SLE) have accelerated atherogenesis. A recent study suggested that Chlamydia pneumoniae infection might also be a contributing factor in the development of atherogenesis in patients with SLE. The objective of this study was to investigate the possible association of C. pneumoniae infection with markers of atherosclerosis in adolescents with SLE compared with age-matched healthy controls. History and exam focused on cardiovascular risk factors were obtained from 20 patients with SLE and 20 age- and sex-matched controls. Laboratory studies included serum lipid profile and high-sensitivity C-reactive protein (hsCRP). Detection of C. pneumoniae in peripheral blood mononuclear cells (PBMCs) and in nasopharyngeal swab specimens was performed. Carotid Intima-Media Thickness (CIMT) was determined by sonography in all subjects. C. pneumoniae DNA was not detected in PBMCs of any of the patients or controls. Nasopharyngeal cultures were also negative for C. pneumoniae in all patients. CIMT was slightly higher in the SLE group (0.48 ± 0.049) compared with controls (0.454 ± 0.041, p = 0.29). There was no significant difference between the two groups in body mass index, blood pressure, hsCRP, and serum cholesterol (total, LDL and HDL). Serum triglycerides were higher in the lupus group (p = 0.03). Children and adolescents with SLE might have accelerated atherosclerosis; however, we did not observe an association with C. pneumoniae infection in this population.

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References

  1. Apfalter P, Barousch W, Nehr M, et al. (2003) Comparison of a new quantitative ompA-based real-time PCR TaqMan assay for detection of Chlamydia pneumoniae DNA in respiratory specimens with four conventional PCR assays. J Clin Microbiol 41:592–600

    Article  PubMed  CAS  Google Scholar 

  2. Apfalter P, Assadian O, Blasi F, et al. (2002) Reliability of nested PCR for detection of Chlamydia pneumoniae DNA in atheromas: results from a multicenter study applying standardized protocols. J Clin Microbiol 40:4428–4434

    Article  PubMed  CAS  Google Scholar 

  3. Apfalter P, Hammerschlag MR, Boman J (2003) Reliability of nested PCR for the detection of Chlamydia pneumoniae in carotid artery atherosclerosis. Stroke 34:e73–75

    Article  PubMed  CAS  Google Scholar 

  4. Boman J, Hammerschlag MR (2002) Chlamydia pneumoniae and atherosclerosis: a critical assessment of diagnostic methods and relevance to treatment studies. Clin Microbiol Rev 15:1–20

    Article  PubMed  CAS  Google Scholar 

  5. Bots ML, Evans GW, Riley WA, Grobbee DE (2003) Carotid intima-media thickness measurements in intervention studies. Design options, progression rates, and sample size considerations: a point of view. Stroke 34:2985–2994

    Article  PubMed  Google Scholar 

  6. Chirgwin K, Roblin PM, Gelling M, et al. (1991) Infection with Chlamydia pneumoniae in Brooklyn. J Infect Dis 163:757–761

    PubMed  CAS  Google Scholar 

  7. Cuomo S, Guarini P, Gaeta G, et al. (2002) Increased carotid intima-media thickness in children-adolescents, and young adults with a parental history of premature myocardial infarction. Eur Heart J 23:1345–1350

    Article  PubMed  CAS  Google Scholar 

  8. Danesh JP, Whincup M, Walker L, et al. (2000) Low-grade inflammation and coronary heart disease: prospective study and updated meta-analyses. Br Med J 321:199–204

    Article  CAS  Google Scholar 

  9. Del Sol AI, Moons KG, Hollander M, et al. (2001) Is carotid intimal-medial thickness useful in cardiovascular disease risk assessment? The Rotterdam study. Stroke 32:1532–1538

    PubMed  Google Scholar 

  10. Falaschi F, Ravelli A, Martignoni A, et al. (2000) Nephrotic range proteinuria, the major risk factor for early atherosclerosis in juvenile-onset systemic lupus erythematosus. Arthritis Rheum 43:1405–1409

    Article  PubMed  CAS  Google Scholar 

  11. Gazarian M, Feldman BM, Benson LN, Gilday DL, Laxer RM, Silverman ED (1998) Assessment of myocardial perfusion and function in childhood systemic lupus erythematosus. J Pediatr 132:109–116

    Article  PubMed  CAS  Google Scholar 

  12. Goyal M, Miller ST, Hammerschlag MR, et al. (2004) Is Chlamydia pneumoniae infection associated with stroke in children with sickle cell disease? Pediatrics 113:e318–321

    Article  PubMed  Google Scholar 

  13. Hammerschlag MR (2003) Pneumonia due to Chlamydia pneumoniae in children: epidemiology, diagnosis and treatment. Pediatr Pulmonol 36:384–390

    Article  PubMed  Google Scholar 

  14. Hammerschlag MR (2004) Chlamydia trachomatis and Chlamydia pneumoniae infections in children and adolescents. Pediatr Rev 25:43–51

    Article  PubMed  Google Scholar 

  15. Hyman CL, Roblin PM, Gaydos CA, Quinn TC, Schachter J, Hammerschlag MR (1995) Prevalence of asymptomatic nasopharyngeal carriage of Chlamydia pneumoniae in subjectively healthy adults: assessment by polymerase chain reaction-enzyme immunoassay and culture. Clin Infect Dis 20:1174–1178

    PubMed  CAS  Google Scholar 

  16. Ilowite NT (2000) Premature atherosclerosis in systemic lupus erythematosus. J Rheumatol 58(Suppl):15–19

    CAS  Google Scholar 

  17. Jourdan C, Wuhl E, Mieczyslaw L, et al. (2005) Normative values for intima-media thickness and distensibility of large arteries in healthy adolescents. J Hypertens 23:1707–1715

    Article  PubMed  CAS  Google Scholar 

  18. Kieltyka L, Urbina EM, Tang R, et al. (2003) Framingham risk score is related to carotid intimal-medial thickness in both white and black young adults: the Bogalusa Heart study. Artherosclerosis 170:125–130

    Article  CAS  Google Scholar 

  19. Kitumnuaypong T, Scalzi LV, Nalbant S, et al. (2004) Is there a role for Chlamydia pneumoniae infection in systemic lupus erythematosus and in the associated atherosclerotic cardiovascular disease? Clin Exp Rheumatol 22:339–342

    PubMed  CAS  Google Scholar 

  20. Kohlhepp SJ, Hardick J, Gaydos C (2005) Chlamydia pneumoniae in peripheral blood mononuclear cells isolated from individuals younger than 20 years or older than 60 years. J Clin Microbiol 43:3030–3034

    Article  PubMed  CAS  Google Scholar 

  21. Kol A, Libby P (1998) The mechanisms by which infectious agents may contribute to atherosclerosis and its clinical manifestations. Trends Cardiovasc Med 8:191–199

    Article  PubMed  CAS  Google Scholar 

  22. Oei HH, Vliegenthart R, Hak AE, et al. (2002) The association between coronary calcification assessed by electron beam computed tomography and measures of extracoronary atherosclerosis: the Rotterdam Coronary Calcification Study. J Am Coll Cardiol 39:1745–1751

    Article  PubMed  Google Scholar 

  23. Oren A, Vos LE, Uiterwaal CS, et al. (2003) Cardiovascular risk factors and increased carotid intimal-medial thickness in healthy young adults: the Artherosclerosis Risk in Young Adults (ARYA) study. Arch Intern Med 163:1787–1792

    Article  PubMed  Google Scholar 

  24. Riley WA (2004) Cardiovascular risk assessment in individual patients from carotid intimal-medial thickness measurements. Curr Artheroscler Rep 6:225–231

    Article  Google Scholar 

  25. Roblin PM, Dumornay W, Hammerschlag MR (1992) Use of HEp-2 cells for improved isolation and passage of Chlamydia pneumoniae. J Clin Microbiol 30:1968–1971

    PubMed  CAS  Google Scholar 

  26. Roman MJ, Shanker BA, Davis A, et al. (2003) Prevalence and correlates of accelerated atherosclerosis in systemic lupus erythematosus. N Engl J Med 349:2399–2406

    Article  PubMed  CAS  Google Scholar 

  27. Rubba P, Iannuzzi A, Faccenda F, et al. (2001) Non-invasive vascular detection of early signs of atherosclerosis in hypercholesterolemic children: why and how. Nutr Metab Cardiovasc Dis 5:10–15

    Google Scholar 

  28. Sass C, Herbeth B, Chapet O, Siest G, Visvikis S, Zannad F (1998) Intima-media thickness and diameter of carotid and femoral arteries in children, adolescents and adults from the Stanislas cohort: effect of age, sex, anthropometry and blood pressure. J Hypertens 16:1593–1602

    Article  PubMed  CAS  Google Scholar 

  29. Schanberg LE, Sandborg C (2004) Dyslipoproteinemia and premature atherosclerosis in pediatric systemic lupus erythematosus. Curr Rheumatol Rep 6:425–433

    Article  PubMed  Google Scholar 

  30. Selzer F, Sutton-Tyrrell K, Fitzgerald SG, et al. (2004) Comparison of risk factors for vascular disease in the carotid artery and aorta in woman with systemic lupus erythematosus. Arthritis Rheum 50:151–159

    Article  PubMed  Google Scholar 

  31. Smieja S, Mahony J, Petrich A, Boman J, Chernesky M (2002) Association of circulating Chlamydia pneumoniae DNA with cardiovascular disease: a systematic review. BMC Infect Dis 2:21

    Article  PubMed  Google Scholar 

  32. Stein JH, Douglas PS, Srinivasan SR, et al. (2004) Distribution and cross-sectional age-related increases of carotid artery intima-media thickness in young adults: the Bogalusa Heart Study. Stroke 35:2782–2787

    Article  PubMed  Google Scholar 

  33. Volanen I, Jarvisalo MJ, Vainionpaa R, et al. (2006) Increased aortic intima-media thickness in 11-year-old healthy children with persistent Chlamydia pneumoniae seropositivity. Arterioscler Thromb Vasc Biol 26(3):649–55

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The authors thank Jeremy Weedon, PhD for statistical interpretation and Andrew D. Bowser for editorial support.

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Authors and Affiliations

  1. Division of Allergy and Immunology, Department of Pediatrics, State University of New York Downstate Medical Center, Brooklyn, NY, USA

    Corinna S. Bowser & Hamid Jack Moallem

  2. Division of Pediatric Infectious Diseases, Department of Pediatrics, State University of New York Downstate Medical Center, Brooklyn, NY, USA

    Swati Kumar, Andrei Kutlin, Stephan Kohlhoff & Margaret R. Hammerschlag

  3. Division of Cardiology, Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, USA

    Louis Salciccioli, Jason Lazar & Imran Rahim

  4. Division of Adolescent Medicine, Department of Pediatrics, State University of New York Downstate Medical Center, Brooklyn, NY, USA

    Amy Suss

Authors
  1. Corinna S. Bowser
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  2. Swati Kumar
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  3. Louis Salciccioli
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  4. Andrei Kutlin
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  7. Amy Suss
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  8. Stephan Kohlhoff
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  9. Margaret R. Hammerschlag
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Correspondence to Corinna S. Bowser.

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Bowser, C.S., Kumar, S., Salciccioli, L. et al. Absence of Chlamydia pneumoniae and Signs of Atherosclerotic Cardiovascular Disease in Adolescents with Systemic Lupus Erythematosus. Pediatr Cardiol 29, 545–551 (2008). https://doi.org/10.1007/s00246-007-9131-x

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  • DOI: https://doi.org/10.1007/s00246-007-9131-x

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