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Detection of viable Chlamydia pneumoniae in abdominal aortic aneurysms.
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. (Klinisk bakteriologi, L Engstrand)
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. (Klinisk bakteriologi, L Engstrand)
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. (Klinisk bakteriologi, L Engstrand)
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. (Klinisk bakteriologi, L Engstrand)
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2000 (English)In: Eur J Vasc Endovasc Surg, Vol. 19, 630- p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2000. Vol. 19, 630- p.
Identifiers
URN: urn:nbn:se:uu:diva-54540OAI: oai:DiVA.org:uu-54540DiVA: diva2:82449
Available from: 2008-10-17 Created: 2008-10-17 Last updated: 2011-01-14
In thesis
1. The Role of Chlamydophila Pneumoniae in the Inflammatory Response and Expansion of Abdominal Aortic Aneurysms
Open this publication in new window or tab >>The Role of Chlamydophila Pneumoniae in the Inflammatory Response and Expansion of Abdominal Aortic Aneurysms
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Abdominal aortic aneurysm (AAA) is a common disease that develops gradually over several years and is characterised by weakening and dilatation of the aortic wall. AAAs also demonstrates a marked inflammatory infiltrate throughout the aortic wall. Chlamydophila pneumoniae (C. pneumoniae), is a common bacterium. About 50% of the population has been infected in adolescence. Thirteen studies report the presence of either C. pneumoniae or its antigens in 35-100% of AAA specimens.

The overall aim of this thesis was to evaluate the possible role of C. pneumoniae in inflammatory response and expansion of AAA from a clinical point of view.

In paper I, viable C. pneumoniae was detected in a majority of 26 patients with AAA having open surgery. Patients operated for AAA had higher C. pneumoniae antibodies titers than controls. In paper II, 247 patients were randomised in a double-blind trial, to evaluate the effect of azithromycin on the expansion of small AAAs. No such effect was seen and there was no correlation between C. pneumoniae antibody titers and AAA expansion. In paper III, 42 patients with AAA were compared to 100 age- and sex matched controls with normal aortas. C. pneumoniae antibodies were analysed in plasma samples obtained at screening, and in samples from a study conducted 5-15 (mean 12) years previously on the same population. There was no significant difference between the groups. In paper IV, were 211 patients were analysed, we could not find an association between levels in plasma of three markers of inflammation (IL-6, MMP-9 and CRP) and AAA expansion. A significant reduction in AAA expansion rate was found in patients treated with a combination of ASA and statins.

In conclusion, viable C. pneumoniae is found at the scene of the crime, but we were unable to reverse or halt expansion of AAA with antibiotic treatment. C. pneumoniae antibody titers cannot be used, to detect small AAA, or to evaluate AAA expansion. From a clinical point of view, based on the methods and analyses used in this thesis, the role of C. pneumoniae in the inflammatory response and expansion of abdominal aortic aneurysms is limited.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 85 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 485
Keyword
Abdominal aortic aneurysm, Chlamydophila pneumoniae, inflammation, aspirin, statin, expansion, randomised clinical trial
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:uu:diva-108867 (URN)978-91-554-7617-5 (ISBN)
Public defence
2009-11-06, Auditorium Minus, Museum Gustavianum, Akademigatan 3, Uppsala, 13:00 (English)
Opponent
Supervisors
Available from: 2009-10-16 Created: 2009-10-01 Last updated: 2009-10-16Bibliographically approved

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