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(Stroke. 1998;29:773-778.)
© 1998 American Heart Association, Inc.


Original Contributions

Distribution of Chlamydia pneumoniae Infection in the Atherosclerotic Carotid Artery

Katsuhiro Yamashita, MD; Kazunobu Ouchi, MD; Mutsunori Shirai, MD; Toshikazu Gondo, MD; Teruko Nakazawa, MD; Haruhide Ito, MD

From the Departments of Neurosurgery (K.Y., H.I.), Microbiology (M.S., T.N.), and Pathology (T.G.), Yamaguchi University School of Medicine, Yamaguchi, Japan, and the Department of Pediatrics, Saiseikai Shimonoseki General Hospital (K.O.), Shimonoseki, Japan.

Correspondence to Katsuhiro Yamashita, Department of Neurosurgery, Yamaguchi University School of Medicine, 1144 Kogushi, Ube, Yamaguchi, 755 Japan. E-mail yamasita-ygc{at}umin.u-tokyo.ac.jp

Background and PurposeChlamydia pneumoniae infection has recently become noteworthy in relation to atherosclerosis. We investigated by immunohistochemistry the distribution of C pneumoniae infection in the atherosclerotic carotid artery.

Methods—Twenty carotid atherosclerotic lesions that were resected during carotid endarterectomy were investigated. Parallel sections were stained immunohistochemically with monoclonal antibodies for a C pneumoniae–specific antigen, macrophages, and smooth muscle cells.

Results—Immunoreactivity for the C pneumoniae–specific antigen was observed in 11 of 20 specimens (55%), and intense immunoreactivity was observed in 7 of 20 (35%). C pneumoniae infection was observed in endothelial cells, macrophages and in smooth muscle cells that had migrated into the atheromatous plaque, as well as in smooth muscle cells and small arteries in the media underlying the atheromatous plaques. C pneumoniae infection was most prominently observed in smooth muscle cells. The severity of the infection as demonstrated by immunohistochemistry was not significantly related to general risk factors for atherosclerosis.

ConclusionsC pneumoniae widely infects endothelial cells, macrophages, and smooth muscle cells in the atherosclerotic carotid artery. The results of the present study can help us to understand how C pneumoniae infection contributes to the progression of carotid atherosclerosis.


Key Words: atherosclerosis • carotid arteries • Chlamydia pneumoniae • infection




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