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- Hjelm, Eva, et al.
(författare)
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Antibodies to Chlamydia pneumoniae in young Swedish orienteers
- 2001
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 33:8, s. 589-592
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Tidskriftsartikel (refereegranskat)abstract
- During 1992-93 sera from 1790 Swedish elite orienteers were tested for antibodies to Chlamydia pneumoniae. The reason for this was that a cluster of 16 cases of sudden unexpected cardiac death had occurred among Swedish orienteers and DNA from C. pneumoniae had been found in the myocarditic heart and in the lung in 1 of 2 deceased athletes in whom testing was feasible; in addition, C. pneumoniae IgG was found in all 5 cases where serum was available. Among the orienteers, the prevalence rates of IgG antibodies in males and females were 54% (n = 1194) and 50% (n = 596), respectively. The corresponding figures for 319 male and female blood donors were 60% (n = 169) and 53% (n = 150), respectively. These differences are not statistically significant. Male orienteers had a lower prevalence of IgA antibodies than male blood donors (19% and 26%, respectively; p < 0.05), while no such difference was found in females (16% and 18%). The prevalence of IgM antibodies was < 1% in all groups. Neither the performance level of the orienteers nor the place of residence affected the antibody prevalence. In conclusion, Swedish orienteers do not show a higher prevalence of antibodies to C. pneumoniae than healthy blood donors.
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- Karlsson, Lars, et al.
(författare)
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A family with abdominal aortic aneurysms
- 2003
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Ingår i: Angiology. - : SAGE Publications. - 0003-3197 .- 1940-1574. ; 54:2, s. 177-180
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Tidskriftsartikel (refereegranskat)abstract
- This investigation focused on 7 siblings to 2 brothers with abdominal aortic aneurysm (AAA), with respect to AAA, Chlamydia pneumoniae (CP) serology, serum cholesterol, and smoking habits. Five male and 4 female siblings were included. All siblings underwent ultrasonography, and surgical specimens from the aorta were prepared for immunohistochemical (IHC) analysis. Blood was obtained from all living siblings and serum cholesterol level was analyzed. Serologic analysis was done by microimmunofluorescence (MIF). Smoking habits were recorded. In addition to the 2 known siblings with AAA, 2 other brothers with AAA were found. Four of 8 siblings had IgG 1/512 or greater and 7 of 8 had IgA 1/64 or greater. Two of 3 were positive for CP in IHC obtained from aortic specimens. Two of 8 had hypercholesterolemia; 7 of 9 were smokers. C. pneumoniae as well as smoking seems to be important in the pathogenesis of AAA in this small cohort; however, larger patient cohorts are needed.
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- Normann, Erik, et al.
(författare)
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Chlamydia pneumoniae infection predicts a reduced risk for subsequent atopic disease.
- 2005
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Ingår i: Acta Paediatr. - 0803-5253. ; 94:6, s. 705-10
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate long-term effects on children previously infected with Chlamydia pneumoniae. METHODS: A follow-up questionnaire was sent to all participants from a former population-based study in order to investigate health status during the 4 y that had elapsed between the two studies. In the original study, the prevalence of C. pneumoniae infection was 23% as determined by PCR analyses on throat swab specimens. These PCR results were found to have no detectable correlation for clinical disease. The main outcome measures in this follow-up study were the reported prevalence of respiratory tract infections, asthma and allergy. RESULTS: Approximately 83% completed the follow-up questionnaire. No increase in respiratory tract infections was reported by children previously found to have C. pneumoniae infection. A diagnosis of allergy was more common in the former PCR-negative population (13.4% vs 4.7%, p<0.03). The differences were most apparent in the population with atopic heredity. In a logistic regression model with different suggested risk factors for allergy, earlier infection with C. pneumoniae reduced the risk for allergy (OR=0.13; 95% CI: 0.02-0.99). This was not found for asthma. CONCLUSION: A positive PCR test for C. pneumoniae in young children was associated with a lower risk of developing allergic airway disease in this study population, and did not predict an increase in respiratory tract infections.
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- Schmidt, Caroline, 1966, et al.
(författare)
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Chlamydia pneumoniae seropositivity is associated with carotid artery intima-media thickness
- 2000
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Ingår i: Stroke. - 0039-2499 .- 1524-4628. ; 31:7, s. 1526-1531
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Infection may both augment the atherosclerotic process and contribute to later manifestations of overt clinical disease. Chlamydia pneumoniae elementary bodies have been detected in atherosclerotic lesions. The aim of the present study was to investigate whether elevated titers of antibodies and circulating immune complexes to C pneumoniae were associated with ultrasound findings indicating presence of atherosclerosis in the carotid artery. METHODS: Serum titers of antibodies to C pneumoniae (IgM, IgA, IgG, and circulating immune complex) were related to intima-media thickness (IMT) and plaque status measured by B-mode ultrasound in the carotid artery in 113 men with treated hypertension and at least 1 of the following risk factors: hypercholesterolemia, smoking, or diabetes. RESULTS: Any of the titers was elevated in 56 (50%) men, and common carotid artery IMT was thicker in this group compared with the 57 men without any elevated titers (1.00 versus 0.92 mm, P<0.05). There were no accompanying differences in blood pressure, lipid levels, blood glucose, or smoking. Elevation of separate antibody types and circulation immune complex were also associated with increased IMT. In the latter group, systolic blood pressure was higher among seropositive patients compared with those who had no circulating immune complex. Seropositivity was not related to plaque status. CONCLUSIONS: Seropositivity for C pneumoniae was associated with an increased intima-media thickness in the common carotid artery but not plaque status in hypertensive men at high risk for cardiovascular disease.
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- Karlsson, Lars, 1959-, et al.
(författare)
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The effect of azithromycin and Chlamydophila pneumoniae infection on expansion of small abdominal aortic aneurysms : a prospective randomised double-blind trial
- 2009
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Ingår i: Journal of Vascular Surgery. - : Elsevier BV. - 0741-5214 .- 1097-6809. ; 50:1, s. 23-29
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of the study was to evaluate the effect of azithromycin on the expansion rate of small abdominal aortic aneurysms (AAAs), and to determine whether or not a correlation exists between serological markers for Chlamydophilia pneumonia (Cpn) infection and AAA expansion. METHODS: Nine vascular centers were included and 259 patients were invited to participate. Ten patients declined and 2 patients had chronic kidney failure, leaving a total of 247 patients. Inclusion criteria were: AAA 35-49 mm and age <80 years. Patients were randomized to receive either azithromycin (Azithromax, Pfizer Inc, New York, NY) 600 mg once daily for 3 days and then 600 mg once weekly for 15 weeks, or placebo in identical tablets. The ultrasound scans were performed in a standardized way within a month before inclusion and every 6 months for a minimum follow-up time of 18 months. Cpn serology was analyzed in blood samples taken at inclusion and 6 months later. Serum was analyzed for Cpn IgA and IgG antibodies by microimmunofluorescence (MIF). Computed tomography (CT) scans were done in 66 patients at inclusion and at 1 year for volume calculations. RESULTS: Thirty-four patients were excluded, ie, could not be followed for 18 months, 20 in the placebo group and 16 in the active treatment group. A total of 211 patients had at least two measurements and all were analyzed in an intention-to-treat analysis. Detectable IgA against Cpn was found in 115 patients and detectable IgG against Cpn in 160 patients. No statistically significant differences were found between the groups regarding median expansion rate measured by ultrasound scan (0.22 cm/year, interquartile range [IQR]: 0.09 to 0.34 in the placebo group vs 0.22, IQR: 0.12 to 0.36 in the treatment group, P = .85). Volume calculation did not change that outcome (10.4 cm(3)/year in the placebo group vs 15.9 cm(3)/year in the treatment group, P = .61). No correlation was found between serological markers for Cpn infection and the expansion rate. Patients taking statins in combination with acetylsalicylic acid (ASA) had significantly reduced expansion rate compared to patients who did not take statins or ASA, 0.14 cm/year vs 0.27 cm/year, P < .001. CONCLUSION: Azithromycin did not have any effect on AAA expansion. No correlation was found between serological markers for Cpn and AAA expansion, indicating no clinical relevance for Cpn testing in AAA surveillance. However, a significant reduction in AAA expansion rate was found in patients treated with a combination of ASA and statins.
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- Normann, Erik, 1966-
(författare)
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Chlamydia pneumoniae in Children - Epidemiology and Clinical Implications
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Chlamydia pneumoniae is a human respiratory tract pathogen. Seroepidemiological studies indicate that C. pneumoniae infection is most common in school-aged children and infrequently detected in younger children.The aims of this study were to further elucidate the prevalence of C. pneumoniae in paediatric populations and to describe the clinical implications of these infections.The study population consisted of 367 children with respiratory tract diseases, 453 presumed healthy children at day-care, 69 children undergoing adenoidectomy and 1585 children from a population based cohort. Family members to infected day-care children were investigated. The laboratory methods used were polymerase chain reaction (PCR) on specimen from upper respiratory tract, serology by microimmunofluorescence (MIF), and immunohistochemistry (IHC) on adenoid tissue specimen. Personal data and medical history were obtained by the means of questionnaires and by the study of patient records.In children younger than five years, the prevalence of C. pneumoniae was 17% as detected by PCR. This prevalence started to increase with increasing age from two years of age. The corresponding increase in serology as detected by MIF started at the age of four years. The prevalence at day-care centres varied from 4 to 39%. Both PCR and MIF underestimated the prevalence of C. pneumoniae detected by IHC. Families to infected children were investigated: mothers were more often infected than fathers were.Most C. pneumoniae infections in small children were confined to the upper respiratory tract. These infections were usually mild or asymptomatic. Symptomatic disease may be of prolonged nature. No subsequent illness after C. pneumoniae infection was detected at follow-up after four years. In general, no association between C. pneumoniae and asthma was found, but C. pneumoniae may be of importance for asthma in some susceptible individuals. Previous C. pneumoniae infection reduced the risk for later atopy.In conclusion, C. pneumoniae is a common finding in small children and most often causes relatively mild disease. If the acquisition of this infection early in life will have any implications for future health remains to be investigated.
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- Unge, Peter, et al.
(författare)
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Amoxicillin added to omeprazole prevents relapse in the treatment of duodenal ulcer patients
- 1993
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Ingår i: European Journal of Gastroenterology and Hepathology. - 0954-691X .- 1473-5687. ; 5:5, s. 325-332
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate two different therapies, omeprazole/amoxicillin versus omepra-zole alone, in the treatment of duodenal ulcer patients with respect to eradication of Helicobacter pylori and time in remission during a 6-month follow-up after cessation of therapy.Design: Double-blind, randomized, parallel groups.Setting: Outpatient referrals in nine Swedish centres.Patients: This study included 248 patients with active duodenal ulcer.Main outcome measures: Endoscopic and symptomatic evaluation of time in remission. Culture, histology and serology for determination of H. pylori status.Results: Eradication of H. pylori was 54 compared with 4% and the proportion of patients in remission at 6 months was 70 compared with 36% in the omeprazole/amoxicillin treated group versus the group treated with omeprazole alone. Of the patients who became H. pylori-negative, 84% were in remission throughout the study.Conclusion: H. pylori is an almost obligate prerequisite for duodenal ulcer disease. Amoxicillin added to omeprazole nearly doubled the proportion of patients in remission at 6 months follow-up. The eradication rate of H. pylori in patients with excellent compliance was 74%.
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