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International Angiology 2002 June;21(2):173-9


language: English

Clinical manifestations of atherosclerosis in an elderly population are related to plasma neopterin, NGAL and endothelin-1, but not to Chlamydia pneumoniae serology

Forsblad J. 1, 4, Gottsäter A. 1, Persson K. 2, Jacobsson L. 3, Lindgärde F. 1

Departments of 1 Vascular Diseases, University of Lund, 2 Clinical Microbiology and 3 Rheumatology, Malmö University Hospital, Malmö, Sweden 4 Department of Internal Medicine, Central Hospital Helsingborg, Helsinborg, Sweden


Back­ground. Inflam­ma­to­ry medi­a­tors secret­ed by leu­ko­cytes are impli­cat­ed in ather­o­gen­e­sis. Chla­myd­ia (C.) pneu­mon­i­ae infec­tion has been sug­gest­ed as a trig­ger of this pro­cess. We inves­ti­gat­ed rela­tion­ships ­between C. Pneu­mon­i­ae serol­o­gy, inflam­ma­to­ry medi­a­tors and symp­to­mat­ic car­di­o­vas­cu­lar dis­ease in old age.
Meth­ods. In a cross-sec­tion­al study at base­line with a pros­pec­tive 4 year fol­low-up, intra­plate­let ­cyclic 3´-5´aden­o­sine mono­phos­phate (cAMP) and ­cyclic 3´-5´gua­no­sine mono­phos­phate (cGMP), plas­ma neu­troph­il gelat­i­nase asso­ciat­ed lipoc­al­in (NGAL), plas­ma­ sol­u­ble tumor necro­sis fac­tor recep­tor-1 (TNFR-1) plas­ma n­e­op­te­rin and plas­ma en­doth­e­lin-1 (ET-1) were ana­lysed togeth­er with IgG and IgA anti­bod­ies for C. Pneu­mon­i­ae in an eld­er­ly ref­er­ence pop­u­la­tion (n=140, ­median age 71 years, 71 ­females). Twen­ty-one sub­jects had clin­i­cal man­i­fes­ta­tions of car­di­o­vas­cu­lar dis­ease at base­line and ­another 21 were diag­nosed with car­di­o­vas­cu­lar dis­ease dur­ing fol­low-up.
­Results. In age adjust­ed logis­tic regres­sion, sub­jects with car­di­o­vas­cu­lar dis­ease ­showed high­er plas­ma lev­els of neop­te­rin (p=0.02), NGAL (p=0.04), and ET-1 (p<0.01). If sub­jects with car­di­o­vas­cu­lar dis­ease at base­line were exclud­ed from the anal­y­sis, high­er plas­ma n­e­op­te­rin (p=0.01) and lower serum HDL cho­les­te­rol (p=0.03) pre­dict­ed car­di­o­vas­cu­lar dis­ease dur­ing fol­low-up. The pres­ence of IgG or IgA ­against C. pneu­mon­i­ae was not asso­ciat­ed with car­di­o­vas­cu­lar dis­ease. Nei­ther were there any asso­ci­a­tions ­between inflam­ma­to­ry or endo­the­lial param­e­ters and C. pneu­mon­i­ae serol­o­gy.
Con­clu­sions. The inflam­ma­to­ry medi­a­tors neop­te­rin and NGAL and endo­the­lial ­derived vas­o­con­stric­tive ET-1 were ­increased in eld­er­ly sub­jects with symp­to­mat­ic car­di­o­vas­cu­lar dis­ease. ­Increased plas­ma n­e­op­te­rin pre­dict­ed car­di­o­vas­cu­lar dis­ease dur­ing fol­low-up. No rela­tion­ships were found ­between C. Pneu­mon­i­ae serol­o­gy and car­di­o­vas­cu­lar dis­ease.

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