Halme S, Syrjälä H, Bloigu A, Saikku P, Leinonen M, Airaksinen J, Surcel H M
National Public Health Institute, Oulu, Finland.
Eur Heart J. 1997 Jul;18(7):1095-101. doi: 10.1093/oxfordjournals.eurheartj.a015403.
To clarify the relationship of Chlamydia pneumoniae infection and coronary atherosclerosis we studied cell-mediated and humoral immune responses to Chlamydia in 93 patients with angiographically confirmed coronary heart disease and in 115 controls without angiographically demonstrable lesions.
Cell-mediated responses were analysed by measuring lymphocyte proliferative reactivity to whole elementary body antigens of C. pneumoniae. Control antigens included C. trachomatis and purified protein derivative of tuberculin. Chlamydia-specific antibodies were measured using microimmunofluorescence assay. Marked C. pneumoniae-specific immune reactivity, demonstrated by the high incidence of elevated IgG and IgA antibodies and strong lymphocyte proliferative response, was associated with coronary heart disease in male but not in female patients or controls. In male patients, the cell-mediated responses were strong to C. pneumoniae (median stimulation index 9,6) and to C. trachomatis (stimulation index 6,9). The females with coronary heart disease showed significantly stronger cell-mediated responses to C. pneumoniae (stimulation index 6,5) than to C. trachomatis (3,8; P < 0.001) and were comparable to the controls.
Marked cell-mediated and humoral immunity to C. pneumoniae in males with coronary heart disease suggest that the immune mechanisms triggered by Chlamydia are a possible contributing factor in the disease pathogenesis of coronary atherosclerosis in males. The Chlamydia-specific cell-mediated responses seem to be predominantly induced by antigenic structures that are similar among different Chlamydia-species.
为阐明肺炎衣原体感染与冠状动脉粥样硬化之间的关系，我们研究了93例经血管造影证实患有冠心病的患者以及115例无血管造影可见病变的对照者对衣原体的细胞介导免疫和体液免疫反应。
通过检测淋巴细胞对肺炎衣原体全原体抗原的增殖反应性来分析细胞介导反应。对照抗原包括沙眼衣原体和结核菌素纯蛋白衍生物。使用微量免疫荧光测定法检测衣原体特异性抗体。IgG和IgA抗体升高的高发生率以及强烈的淋巴细胞增殖反应所显示的明显的肺炎衣原体特异性免疫反应性，与男性冠心病患者相关，而与女性患者或对照者无关。在男性患者中，细胞介导反应对肺炎衣原体（中位刺激指数9.6）和沙眼衣原体（刺激指数6.9）均较强。患有冠心病的女性对肺炎衣原体的细胞介导反应（刺激指数6.5）明显强于对沙眼衣原体的反应（3.8；P<0.001），且与对照者相当。
男性冠心病患者对肺炎衣原体有明显的细胞介导免疫和体液免疫，这表明衣原体触发的免疫机制可能是男性冠状动脉粥样硬化疾病发病机制中的一个促成因素。衣原体特异性细胞介导反应似乎主要由不同衣原体物种间相似的抗原结构诱导产生。
