Humoral immune response to human cytomegalovirus in patients undergoing percutaneous transluminal coronary angioplasty

Possible causal relations between prior human cytomegalovirus (HCMV) infect ion and atherosclerosis and between HCMV reactivation and restenosis after coronary angioplasty have been suggested. We investigated patterns of antib odies directed to HCMV in 112 patients undergoing percutaneous transluminal coronary angioplasty (PTCA) and in a group of sex- and age-matched control s (blood donors without evidence of atherosclerosis), Levels of antibodies to HCMV were measured by enzyme-linked immunosorbent assay (ELISA) of serum samples drawn before and 5 weeks after PTCA. To further differentiate the humoral immune response, we specifically tested antibody reactivity towards four single HCMV proteins (IE2, p52, pp150, and pp65) by recombinant ELISA s. We found that 73% of PTCA patients and 69% of sex- and age-matched contr ols were seropositive for HCMV (odds ratio, 1.2 [not significant]), The cor responding odds ratios for matched pairs ranged in the recombinant ELISAs f rom 1.2 to 1,4, Patients had more often high titers of anti-HCMV antibodies (11 versus 4%; odds ratio = 3.3 [0.9 to 15.2]; P = 0.052) and high titers of anti-pp150 antibodies (13 versus 4%; odds ratio = 6.0 [1.3 to 38.8]; P = 0.008). Anti-HCMV immunoglobulin M antibodies were not detected in any pat ient. There was no evidence of acute HCMV reactivation after PTCA, since th e titers of antibodies to the investigated recombinant proteins did not inc rease at 5 weeks after PTCA, Our results show a limited association between prior HCMV infection and coronary artery disease. We infer that positive a nti-HCMV titers are not a major risk factor at the time of disease manifest ation. However, this study cannot rule out a possible role of HCMV at earli er stages of the atherosclerotic process. Recombinant ELISAs provide a valu able tool for investigating the antiviral immune response.