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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chlamydia pneumoniae has recently been implicated in the pathogenesis of several neurological diseases. As an intracellular parasite with its unusual life cycle it is able to circumvent the immune system and to persist in the organism. It has the ability to modify the function of the infected cell and supposedly induce autoimmune reactions. These properties can make it pathogenic in several chronic neurological diseases including multiple sclerosis, atherosclerosis, stroke, Alzheimer dementia and giant cell arteritis. The evaluation of the available, often contradictory, data that are based on various different methods is not easy. The importance of the issue is enhanced by the potential need for antibiotic treatment.
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PMID:[The significance of Chlamydia pneumoniae in selected neurologic disorders]. 1649 68

The research purposed to investigate the Chlamydia Pneumoniae infection in patients with ischemic stroke and to establish the correlation with elevated C. pneumonia antibody titers and endothelial dysfunction. 72 patients with acute ischemic stroke, aged 45 to 75 (45 male and 32 female) have been researched. Patients were grouped according to etiology of stroke (based on International classification TOAST). The blood was taken in 48 hours from stroke onset. ELISA method was applied to detect the antibodies against C. Pneumoniae. The intima-media thickness of the common carotid artery were assessed by B-mode ultrasonography (Acuson128XP/10) with a 7.5-MHz linear-array transducer. Flow-mediated dilatation (FMD) of the brachial artery were measured from high-resolution, 2-dimensional ultrasound images obtained by an ultrasound machine with a 7.5-MHz linear-array transducer. Free NO were examined by Electron Paramagnetic Resonance (EPR) method in blood. Control consisted with 15 healthy volunteers. Multivariate logistic regression showed a significant positive correlation between blood elevated titers of IgA and IgG of stroke patients and the intima-media thickness of the carotid artery (correlation coefficient by Pearson r = 0,31; p<0,05, r = 0,27; p<0,05). On multiple regression analysis, percent FMD showed a significant negative correlation with the intima-media thickness of the common carotid artery (r= -0,57, p<0,05), positive correlation between NO and the intima-media thickness of the carotid artery (r= 0,72, p<0,05). Association between antibody seropositivity for C. pneumoniae and increase of the IMT in the common carotid artery indicates persistent chronic infection in patients with ischemic stroke. Correlation between NO, an increase of the IMT in the common carotid and artery flow-mediated dilation of brachial artery indicates on the participation of NO in development of endothelial dysfunction and its significant role in pathogenesis of ischemic stroke. These findings support the concept that NO-inducible endothelial dysfunction is related to atherogenesis.
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PMID:[The role of endothelial dysfunction and Chlamydia pneumoniae infection in patients with ischemic stroke]. 1752 3

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.
J Stroke Cerebrovasc Dis
PMID:Lack of association between infectious burden and carotid atherosclerosis in Japanese patients. 1768 10

Recently, Chlamydia pneumoniae has been identified as a risk factor for atherosclerosis, cardiovascular disease, and stroke. In young patients the causes of stroke are more diverse, and remain unknown in about 30% of cases, despite thorough investigations. To find a possible relationship between C. pneumoniae infection and stroke at young age, we investigated C. pneumoniae antibody titers in 41 patients with ischemic stroke who were younger than 50 years old and in 55 healthy control subjects. A positive IgA antibody titer to C. pneumoniae was significantly associated with stroke (crude odds ratio 2.1; 90% confidence interval 1.1-9.5; P = .04). After adjusting for hypertension, smoking, and hypercholesterolemia, positive Chlamydia antibodies remained associated with stroke (adjusted odds ratio 2.8; 90% confidence interval 1.1-7.1; P = .04). No significant association between positive IgG antibodies and stroke was found. Because a positive IgA antibody titer may reflect a persistent infection, these data indicate that persistent C. pneumoniae infection may be an independent risk factor for stroke at young age.
J Stroke Cerebrovasc Dis
PMID:Chlamydia pneumoniae is a likely risk factor for ischemic stroke in young patients. 1790 55

Involvement of infection agents in pathogenesis of atherosclerosis was described in several studies, particularly in patients with acute coronary syndrome or ischemic stroke. However, in very few studies an association of serological markers of chronic infection with peripheral occlusive artery disease was analysed. The prevalence and concentration of immunoglobulin G and A to Chlamydia pneumoniae and immunoglobulin G to CMV were measured in sera of 31 participants suffering from peripheral occlusive artery disease. Significant difference in the prevalance of immunoglobulin G to C. pneumoniae and CMV between study and control groups was documented. There was no such association in reference to immunoglobulin A to C. pneumoniae index. Serum concentration of all measured antibodies were significantly higher in the study group than in control.
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PMID:[Serological markers of chronic Chlamydia pneumoniae and cytomegalovirus (CMV) infection in patients with peripheral occlusive artery disease--an initial report]. 1815 50

Stroke is among the most common causes of death and persisting disability and therefore represents a great social and economic burden worldwide. In order to lower this burden it is essential to identify risk factors and respective preventive strategies. Besides the established stroke risk factors (e.g. hypertension, diabetes, hypercholesterolemia, atrial fibrillation) both acute and chronic infectious diseases have emerged as risk factors for stroke. Mainly acute respiratory tract infection but also urinary tract infections independently increase the risk of ischemic stroke. Such additional risk was shown to be highest for infection within 3 days before ischemia and the risk steadily declines with increasing time intervals between infection and stroke. Associations between stroke incidence and mortality and influenza epidemics have been demonstrated. Observational studies showed an inverse association between influenza vaccination and stroke risk; however, interventional studies in this field have not been performed so far. Chronic infections, presently discussed as stroke risk factors mainly include periodontitis and infections with Helicobacter pylori (Hp) and Chlamydia pneumoniae (Cp). Although most respective studies identified these infectious diseases as independent stroke risk factors interventional trials have not been performed so far and causality is not proven, yet. There is preliminary evidence that the number of pathogens to which a subject had been exposed to rather than single pathogens are associated with the risk of stroke or other cardiovascular diseases. Chronic infectious diseases are treatable conditions and their identification as causal contributors to stroke risk could offer new avenues in stroke prevention.
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PMID:Infection, its treatment and the risk for stroke. 1935 97

Chlamydia pneumoniae has been found to be associated with cerebrovascular and cardiovascular diseases in seroepidemiologic studies. The aim of this study was to investigate whether this organism is associated with increased intima media thickness (IMT) of carotid arteries in asymptomatic individuals. Serum titer of antibodies to C pneumoniae antibodies IgA and IgG in 100 asymptomatic individuals older than 40 years was measured by microimmunofluorescence. These subjects also had their IMT measured by B-mode ultrasound in the common carotid artery on both sides. Comparison of baseline characteristics between the group with abnormal IMT (>0.08 cm) and group having normal IMT (<or=0.08 cm) showed significant association of C pneumoniae antibodies and hypertension with the former (i.e., abnormal IMT group). Multiple logistic regression (stepwise method) established C pneumoniae as an independent risk factor for increased IMT. To conclude, this study demonstrated that C pneumoniae infection is associated with an increase of IMT in the common carotid artery.
J Stroke Cerebrovasc Dis
PMID:Antibodies to Chlamydia pneumoniae are associated with increased intima media thickness in asymptomatic Indian individuals. 1942 88

Chlamydophila pneumoniae is an intracellular pathogen responsible for a number of different acute and chronic infections. The recent deepening of knowledge on the biology and the use of increasingly more sensitive and specific molecular techniques has allowed demonstration of C. pneumoniae in a large number of persons suffering from different diseases including cardiovascular (atherosclerosis and stroke) and central nervous system (CNS) disorders. Despite this, many important issues remain unanswered with regard to the role that C. pneumoniae may play in initiating atheroma or in the progression of the disease. A growing body of evidence concerns the involvement of this pathogen in chronic neurological disorders and particularly in Alzheimer's disease (AD) and Multiple Sclerosis (MS). Monocytes may traffic C. pneumoniae across the blood-brain-barrier, shed the organism in the CNS and induce neuroinflammation. The demonstration of C. pneumoniae by histopathological, molecular and culture techniques in the late-onset AD dementia has suggested a relationship between CNS infection with C. pneumoniae and the AD neuropathogenesis. In particular subsets of MS patients, C. pneumoniae could induce a chronic persistent brain infection acting as a cofactor in the development of the disease. The role of Chlamydia in the pathogenesis of mental or neurobehavioral disorders including schizophrenia and autism is uncertain and fragmentary and will require further confirmation.
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PMID:Chlamydophila pneumoniae Infection and Its Role in Neurological Disorders. 2018 26

Atherosclerotic cardiovascular disease is the main cause of morbidity and mortality for end-stage renal disease patients undergoing chronic haemodialysis (HD). Several studies in recent years have identified Chlamydia pneumoniae, a respiratory pathogen, as risk factor for cardiovascular diseases in the general population. The aim of our study is to evaluate chlamydial load, in peripheral blood mononuclear cells (PBMC) of HD patients. Furthermore, the correlation between DNA chlamydial load and markers of inflammation was also examined. PBMC specimens isolated from 49 HD patients and 46 blood donors were analyzed for the presence of C. pneumoniae DNA by real-time PCR and ompA nested touchdown PCR. In HD patients, plasma levels of several inflammatory markers were also determined. A significantly higher rate of C. pneumoniae DNA was found in HD patients (44.9 percent) than in blood donors (19.6 percent) (p=0.016); HD patients were also more likely to have a significantly high chlamydial load (p=0.0004). HD patients with atherosclerotic cardiovascular diseases have a significantly greater chlamydial load than HD patients without cardiovascular diseases (p= 0.006). A significantly higher value of C-reactive protein, IL-6 and advanced oxidative protein products was found in HD patients with a greater chlamydial load (p less than 0.05). Likewise, a significantly lower monocyte HLA-DR percentage (p=0.011) as well as a lower monocyte HLA-DR expression were found in such patients (p= 0.007). In conclusion, our results show that HD patients are at high risk of C. pneumoniae infection correlated with chronic inflammatory response which in turn can lead to accelerated atherosclerosis and other long-term clinical complications such as myocardial infarction and stroke.
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PMID:Chlamydia pneumoniae infection as a risk factor for accelerated atherosclerosis in hemodialysis patients. 2084 85

The occurrence of stroke in populations is incompletely explained by traditional vascular risk factors. Data from several case-control studies and one large study using case series methodology indicate that recent infection is a temporarily acting, independent trigger factor for ischemic stroke. Both bacterial and viral infections, particularly respiratory tract infections, contribute to this association. A causal role for infection in stroke is supported by a graded temporal relationship between these conditions, and by multiple pathophysiological pathways linking infection and inflammation, thrombosis, and stroke. Furthermore, observational studies suggest that influenza vaccination confers a preventive effect against stroke. Case-control and prospective studies indicate that chronic infections, such as periodontitis, chronic bronchitis and infection with Helicobacter pylori, Chlamydia pneumoniae or Cytomegalovirus, might increase stroke risk, although considerable variation exists in the results of these studies, and methodological issues regarding serological results remain unresolved. Increasing evidence indicates that the aggregate burden of chronic and/or past infections rather than any one single infectious disease is associated with the risk of stroke. Furthermore, genetic predispositions relating to infection susceptibility and the strength of the inflammatory response seem to co-determine this risk. Here, we summarize and analyze the evidence for common acute and chronic infectious diseases as stroke risk factors.
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PMID:Common infections and the risk of stroke. 2106 Mar 40


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