Lack of Association Between Infectious Burden and Carotid Atherosclerosis in Japanese Patients

Hagiwara, Noriko; Toyoda, Kazunori; Inoue, Tooru; Shimada, Hirofumi; Ibayashi, Setsuro; Iida, Mitsuo; Okada, Yasushi

doi:10.1016/j.jstrokecerebrovasdis.2007.02.001

« Previous Next »Journal of Stroke & Cerebrovascular Diseases
Volume 16, Issue 4 , Pages 145-152, July 2007

Lack of Association Between Infectious Burden and Carotid Atherosclerosis in Japanese Patients

Noriko Hagiwara, MD
- Department of Cerebrovascular Disease, Cerebrovascular Center and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
- Address reprint requests to Noriko Hagiwara, MD, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Kazunori Toyoda, MD, PhD
- Department of Cerebrovascular Disease, Cerebrovascular Center and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
Tooru Inoue, MD, PhD
- Department of Neurosurgery, Cerebrovascular Center and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
Hirofumi Shimada, MT
- Medical Laboratory, Cerebrovascular Center and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
Setsuro Ibayashi, MD, PhD
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Mitsuo Iida, MD, PhD
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Yasushi Okada, MD, PhD
- Department of Cerebrovascular Disease, Cerebrovascular Center and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan

Received 1 November 2006; received in revised form 26 January 2007; accepted 14 February 2007.

Several infectious agents, such as Chlamydia pneumoniae, cytomegalovirus (CMV), herpes simplex virus (HSV), and Helicobacter pylori, have been implicated in the pathogenesis of atherosclerosis; however, but the contribution of infection may vary among races and geographic conditions. The present study investigates the association between the presence of these pathogens and carotid atherosclerosis and examines the relevance of an infectious burden during atherogenesis in Japanese patients undergoing carotid endarterectomy. We investigated a total of 50 carotid atherosclerotic plaques resected during carotid endarterectomy by polymerase chain reaction (PCR) for C. pneumoniae, CMV, HSV, and H. pylori and by immunocytochemistry (ICC) for C. pneumoniae. We also examined the presence of antibodies to IgG and/or IgA for each pathogen in blood samples. We detected HSV DNA in 2 specimens (4%) and positive ICC for C. pneumoniae in 8 (16%). The results of PCR, ICC, or serum antibodies, as well as the number of seropositive antibodies, did not correlate with severely stenotic, ulcerative, or symptomatic plaques. Our findings indicate that the detection rate of infectious agents within atherosclerotic plaques was significantly lower in our patients than that in other studies. Thus, an inflammatory mechanism might not correlate with the pathogenesis of carotid atherosclerosis among Japanese patients with severe carotid artery stenosis.

Key Words: Stroke, carotid stenosis, carotid endarterectomy, Chlamydia pneumoniae, infectious burden