Shimada K, Daida H, Mokuno H, Watanabe Y, Sawano M, Iwama Y, Seki E, Kurata T, Sato H, Ohashi S, Suzuki H, Miyauchi K, Takaya J, Sakurai H, Yamaguchi H
Department of Cardiology, Juntendo University, School of Medicine, Tokyo, Japan.
Jpn Circ J. 2001 Mar;65(3):182-7. doi: 10.1253/jcj.65.182.
Recent studies suggest an association between Chlamydia pneumoniae infection and coronary artery disease (CAD). To examine this relationship in Japanese men, serum IgA and IgG antibodies to Chlamydia-specific lipopolysaccharide were measured by enzyme-linked immunosorbent assay in 507 patients with CAD and 200 age-matched controls. CAD patients were divided into (1) 269 patients with myocardial infarction (MI) and (2) 238 patients with chronic coronary heart disease (CCHD). Compared with the control group, the CAD group did not differ in the prevalences of both antibodies (IgA: 23.7 vs 18.0%, p=0.10; IgG: 52.7 vs 51.0%, p=0.6). The index of IgG antibody was not significantly different between CAD and control groups (median 1.19 vs 1.18, p=0.3), whereas the index of IgA antibody was significantly higher in CAD than control group (median 0.60 vs 0.46, p<0.0001). Compared with the control group, the MI group had a significantly higher prevalence of IgA antibody (28.6 vs 18.0%, p=0.007); however, there was no difference in the prevalence of IgG antibody (58.0 vs 51.0%, p=0.13). The CCHD group did not differ in the prevalences of both antibodies (IgA: 18.1 vs 18.0%, p=0.9; IgG: 45.6 vs 51.0%, p=0.2). After the adjustment for coronary risk factors, odds ratios (ORs) of seropositive antibodies for CAD were 1.59 [95% confidence interval (CI): 0.88-2.87, p=0.12] for IgA seropositivity and 0.92 (95%CI: 0.58-1.47, p=0.7) for IgG seropositivity in all cases. In the MI and control groups, ORs of seropositive antibodies for MI were 2.67 (95%CI: 1.32-5.38, p=0.007) for IgA seropositivity, and 1.36 (95%CI: 0.79-2.36, p=0.2) for IgG seropositivity. This study discovered that IgA antibody to Chlamydia was significantly associated with CAD, especially with MI, in Japanese Men and the findings suggest that chronic infection of Chlamydia may be linked to the pathogenesis of MI.
近期研究表明肺炎衣原体感染与冠状动脉疾病（CAD）之间存在关联。为了在日本男性中研究这种关系，采用酶联免疫吸附测定法检测了507例CAD患者和200例年龄匹配的对照者血清中针对衣原体特异性脂多糖的IgA和IgG抗体。CAD患者被分为：（1）269例心肌梗死（MI）患者和（2）238例慢性冠心病（CCHD）患者。与对照组相比，CAD组两种抗体的患病率无差异（IgA：23.7%对18.0%，p = 0.10；IgG：52.7%对51.0%，p = 0.6）。CAD组和对照组之间IgG抗体指数无显著差异（中位数1.19对1.18，p = 0.3），而CAD组IgA抗体指数显著高于对照组（中位数0.60对0.46，p<0.0001）。与对照组相比，MI组IgA抗体患病率显著更高（28.6%对18.0%，p = 0.007）；然而，IgG抗体患病率无差异（58.0%对51.0%，p = 0.13）。CCHD组两种抗体的患病率无差异（IgA：18.1%对18.0%，p = 0.9；IgG：45.6%对51.0%，p = 0.2）。在对冠状动脉危险因素进行调整后，所有病例中CAD血清阳性抗体的比值比（OR）：IgA血清阳性为1.59[95%置信区间（CI）：0.88 - 2.87，p = 0.12]，IgG血清阳性为0.92（95%CI：0.58 - 1.47，p = 0.7）。在MI组和对照组中，MI血清阳性抗体的OR：IgA血清阳性为2.67（95%CI：1.32 - 5.38，p = 0.007），IgG血清阳性为1.36（95%CI：0.79 - 2.36，p = 0.2）。本研究发现，在日本男性中，衣原体IgA抗体与CAD显著相关，尤其是与MI相关，研究结果表明衣原体慢性感染可能与MI的发病机制有关。
