Chlamydia pneumoniae accompanied by inflammation is associated with the progression of atherosclerosis in CAPD patients: A prospective study for 3 years

Dong Ki Kim, Hyun Jin Kim, Seung Hyeok Han, Jung Eun Lee, Sung Jin Moon, Beom Seok Kim, Shin Wook Kang, Kyu Hun Choi, Ho Yung Lee, Dae Suk Han

Research output: Contribution to journalArticle

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Abstract

Background. The causes of accelerated atherosclerosis in end-stage renal disease (ESRD) patients are unknown, although recent studies have suggested that Chlamydia pneumoniae (Cp) infection and inflammation might be contributing factors. We aimed to evaluate the association of carotid atherosclerosis progression with Cp infection and inflammation in patients undergoing peritoneal dialysis (PD). Methods. This is a prospective observational study. A total of 52 non-diabetic prevalent PD patients were included. The intima-media thickness of a common carotid artery (CCA-IMT) was measured at baseline and after 36 months by B-mode ultrasonography. Serum antibodies to Cp and inflammatory markers were obtained at the time of initial measurement of the CCA-IMT. Results. CCA-IMT progressors (ΔCCA-IMT ≥ 0.015 mm/year) had a higher prevalence of seropositivity for Cp IgA antibody, a higher level of Cp IgA antibodies indices, log IL-(interleukin-)6, and intercellular adhesion molecule-1 (ICAM-1) compared to the non-progressors (ΔCCA-IMT < 0.015 mm/year). On multivariate analysis, Cp IgA index and log IL-6 were independent risk a factors for CCA-IMT progression. Also, Cp IgA index had independent positive correlation with the magnitude of annual ΔCCA-IMT. Cp IgA antibody seropositive patients showed significantly higher mean annual ΔCCA-IMT than seronegative patients. Moreover, patients with both positive Cp IgA antibodies and elevated IL-6 above the median level showed higher ΔCCA-IMT than those with either factor alone. Conclusions. Our data showed that Cp and inflammation were significant risk factors of CCA-IMT change in PD patients. This study strengthens evidence that Cp is involved in the pathogenesis of atherosclerosis and also suggests that the effect of Cp infection under high inflammatory status might be a risk factor for progression of atherosclerosis.

Original languageEnglish
Pages (from-to)1011-1018
Number of pages8
JournalNephrology Dialysis Transplantation
Volume23
Issue number3
DOIs
Publication statusPublished - 2008 Mar 1

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Chlamydophila pneumoniae
Continuous Ambulatory Peritoneal Dialysis
Atherosclerosis
Prospective Studies
Inflammation
Immunoglobulin A
Chlamydia Infections
Interleukin-6
Peritoneal Dialysis
Antibodies
Carotid Artery Diseases
Common Carotid Artery
Intercellular Adhesion Molecule-1
Chronic Kidney Failure
Observational Studies
Ultrasonography
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

Kim, Dong Ki ; Kim, Hyun Jin ; Han, Seung Hyeok ; Lee, Jung Eun ; Moon, Sung Jin ; Kim, Beom Seok ; Kang, Shin Wook ; Choi, Kyu Hun ; Lee, Ho Yung ; Han, Dae Suk. / Chlamydia pneumoniae accompanied by inflammation is associated with the progression of atherosclerosis in CAPD patients : A prospective study for 3 years. In: Nephrology Dialysis Transplantation. 2008 ; Vol. 23, No. 3. pp. 1011-1018.
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title = "Chlamydia pneumoniae accompanied by inflammation is associated with the progression of atherosclerosis in CAPD patients: A prospective study for 3 years",
abstract = "Background. The causes of accelerated atherosclerosis in end-stage renal disease (ESRD) patients are unknown, although recent studies have suggested that Chlamydia pneumoniae (Cp) infection and inflammation might be contributing factors. We aimed to evaluate the association of carotid atherosclerosis progression with Cp infection and inflammation in patients undergoing peritoneal dialysis (PD). Methods. This is a prospective observational study. A total of 52 non-diabetic prevalent PD patients were included. The intima-media thickness of a common carotid artery (CCA-IMT) was measured at baseline and after 36 months by B-mode ultrasonography. Serum antibodies to Cp and inflammatory markers were obtained at the time of initial measurement of the CCA-IMT. Results. CCA-IMT progressors (ΔCCA-IMT ≥ 0.015 mm/year) had a higher prevalence of seropositivity for Cp IgA antibody, a higher level of Cp IgA antibodies indices, log IL-(interleukin-)6, and intercellular adhesion molecule-1 (ICAM-1) compared to the non-progressors (ΔCCA-IMT < 0.015 mm/year). On multivariate analysis, Cp IgA index and log IL-6 were independent risk a factors for CCA-IMT progression. Also, Cp IgA index had independent positive correlation with the magnitude of annual ΔCCA-IMT. Cp IgA antibody seropositive patients showed significantly higher mean annual ΔCCA-IMT than seronegative patients. Moreover, patients with both positive Cp IgA antibodies and elevated IL-6 above the median level showed higher ΔCCA-IMT than those with either factor alone. Conclusions. Our data showed that Cp and inflammation were significant risk factors of CCA-IMT change in PD patients. This study strengthens evidence that Cp is involved in the pathogenesis of atherosclerosis and also suggests that the effect of Cp infection under high inflammatory status might be a risk factor for progression of atherosclerosis.",
author = "Kim, {Dong Ki} and Kim, {Hyun Jin} and Han, {Seung Hyeok} and Lee, {Jung Eun} and Moon, {Sung Jin} and Kim, {Beom Seok} and Kang, {Shin Wook} and Choi, {Kyu Hun} and Lee, {Ho Yung} and Han, {Dae Suk}",
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Chlamydia pneumoniae accompanied by inflammation is associated with the progression of atherosclerosis in CAPD patients : A prospective study for 3 years. / Kim, Dong Ki; Kim, Hyun Jin; Han, Seung Hyeok; Lee, Jung Eun; Moon, Sung Jin; Kim, Beom Seok; Kang, Shin Wook; Choi, Kyu Hun; Lee, Ho Yung; Han, Dae Suk.

In: Nephrology Dialysis Transplantation, Vol. 23, No. 3, 01.03.2008, p. 1011-1018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Chlamydia pneumoniae accompanied by inflammation is associated with the progression of atherosclerosis in CAPD patients

T2 - A prospective study for 3 years

AU - Kim, Dong Ki

AU - Kim, Hyun Jin

AU - Han, Seung Hyeok

AU - Lee, Jung Eun

AU - Moon, Sung Jin

AU - Kim, Beom Seok

AU - Kang, Shin Wook

AU - Choi, Kyu Hun

AU - Lee, Ho Yung

AU - Han, Dae Suk

PY - 2008/3/1

Y1 - 2008/3/1

N2 - Background. The causes of accelerated atherosclerosis in end-stage renal disease (ESRD) patients are unknown, although recent studies have suggested that Chlamydia pneumoniae (Cp) infection and inflammation might be contributing factors. We aimed to evaluate the association of carotid atherosclerosis progression with Cp infection and inflammation in patients undergoing peritoneal dialysis (PD). Methods. This is a prospective observational study. A total of 52 non-diabetic prevalent PD patients were included. The intima-media thickness of a common carotid artery (CCA-IMT) was measured at baseline and after 36 months by B-mode ultrasonography. Serum antibodies to Cp and inflammatory markers were obtained at the time of initial measurement of the CCA-IMT. Results. CCA-IMT progressors (ΔCCA-IMT ≥ 0.015 mm/year) had a higher prevalence of seropositivity for Cp IgA antibody, a higher level of Cp IgA antibodies indices, log IL-(interleukin-)6, and intercellular adhesion molecule-1 (ICAM-1) compared to the non-progressors (ΔCCA-IMT < 0.015 mm/year). On multivariate analysis, Cp IgA index and log IL-6 were independent risk a factors for CCA-IMT progression. Also, Cp IgA index had independent positive correlation with the magnitude of annual ΔCCA-IMT. Cp IgA antibody seropositive patients showed significantly higher mean annual ΔCCA-IMT than seronegative patients. Moreover, patients with both positive Cp IgA antibodies and elevated IL-6 above the median level showed higher ΔCCA-IMT than those with either factor alone. Conclusions. Our data showed that Cp and inflammation were significant risk factors of CCA-IMT change in PD patients. This study strengthens evidence that Cp is involved in the pathogenesis of atherosclerosis and also suggests that the effect of Cp infection under high inflammatory status might be a risk factor for progression of atherosclerosis.

AB - Background. The causes of accelerated atherosclerosis in end-stage renal disease (ESRD) patients are unknown, although recent studies have suggested that Chlamydia pneumoniae (Cp) infection and inflammation might be contributing factors. We aimed to evaluate the association of carotid atherosclerosis progression with Cp infection and inflammation in patients undergoing peritoneal dialysis (PD). Methods. This is a prospective observational study. A total of 52 non-diabetic prevalent PD patients were included. The intima-media thickness of a common carotid artery (CCA-IMT) was measured at baseline and after 36 months by B-mode ultrasonography. Serum antibodies to Cp and inflammatory markers were obtained at the time of initial measurement of the CCA-IMT. Results. CCA-IMT progressors (ΔCCA-IMT ≥ 0.015 mm/year) had a higher prevalence of seropositivity for Cp IgA antibody, a higher level of Cp IgA antibodies indices, log IL-(interleukin-)6, and intercellular adhesion molecule-1 (ICAM-1) compared to the non-progressors (ΔCCA-IMT < 0.015 mm/year). On multivariate analysis, Cp IgA index and log IL-6 were independent risk a factors for CCA-IMT progression. Also, Cp IgA index had independent positive correlation with the magnitude of annual ΔCCA-IMT. Cp IgA antibody seropositive patients showed significantly higher mean annual ΔCCA-IMT than seronegative patients. Moreover, patients with both positive Cp IgA antibodies and elevated IL-6 above the median level showed higher ΔCCA-IMT than those with either factor alone. Conclusions. Our data showed that Cp and inflammation were significant risk factors of CCA-IMT change in PD patients. This study strengthens evidence that Cp is involved in the pathogenesis of atherosclerosis and also suggests that the effect of Cp infection under high inflammatory status might be a risk factor for progression of atherosclerosis.

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U2 - 10.1093/ndt/gfm696

DO - 10.1093/ndt/gfm696

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