ENDOVASCULAR PRESENCE OF CHLAMYDIA-PNEUMONIAE IN PATIENTS WITH HEMODYNAMICALLY EFFECTIVE CAROTID-ARTERY STENOSIS

The bacterial pathogen Chlamydia pneumoniae has been associated with a therosclerosis. Recent studies have reported chlamydial antigen to be present in atherosclerotic coronary arteries, but this relation has no t yet been widely accepted. In order to verify an endovascular presenc e of potentially viable chlamydiae by detection of genomic DNA, the au thors examined atherosclerotic carotid arteries by using a C. pneumoni ae-specific nested polymerase chain reaction. Chlamydial DNA was detec ted in 9 of 61 (15%) arterial samples obtained from therapy of hemodyn amically effective cervical vascular stenosis. Chlamydial presence was limited to advanced atherosclerotic lesions (P less than or equal to 0.02): tissues from the same arteries with early subendothelial lesion s did not harbor the pathogen. Thus, an etiologic role of C. pneumonia e is more plausible for progression than for initiation of atheroscler otic lesions. Histomorphologic discrimination of infected and noninfec ted samples was not possible and serology was unrewarding in detecting the infected patients. Chlamydial occurrence in atheromatous plaques is apparently a general phenomenon of atherosclerosis not limited to c oronary arteries. Endovascular presence of genomic DNA of a bacterial pathogen susceptible to antimicrobial agents encourages thought on a n ew approach to prevent progression of atherosclerosis in a substantial proportion of patients. However, an etiologic contribution of C. pneu moniae in the multifactorial process of atherogenesis yet remains to b e demonstrated.