This Article Full Text Full Text (PDF) All Versions of this Article: 37/3/756    most recent 01.STR.0000201970.88546.5ev1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Apfalter, P. Search for Related Content PubMed PubMed Citation Articles by Apfalter, P. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Stroke Related Collections Risk Factors Other diagnostic testing Carotid Stenosis Related Article

(Stroke. 2006;37:756.)
© 2006 American Heart Association, Inc.

Editorial

Chlamydia pneumoniae, Stroke, and Serological Associations

Anything Learned From the Atherosclerosis-Cardiovascular Literature or Do We Have to Start Over Again?

Petra Apfalter, MD

From the Department of Clinical Microbiology, Institute of Hygiene and Medical Microbiology, National Reference Laboratory for Chlamydia pneumoniae, Vienna General Hospital, Vienna, Austria.

Correspondence to Petra Apfalter, MD, DTMH (Lond), Department of Clinical Microbiology, Institute of Hygiene and Medical Microbiol-ogy, National Reference Laboratory for Chlamydia pneumoniae, Vienna General Hospital, Waehringer Guertel 18-20/5P, 1090 Vienna-AUSTRIA. E-mail petra.apfalter@meduniwien.ac.at

Key Words: Chlamydia pneumoniae • serology • stroke

An extract of the first 250 words of the full text is provided, because this article has no abstract.

There are now more arguments against than for a causal relationship between C. pneumoniae and atherosclerosis. Seroepidemiologic results are largely technique-dependent; PCR results show intra- and interlaboratory variability; methodological factors contribute to bias; and detection of C. pneumoniae fails when the specificity of the reaction is optimized. Immunohistochemical staining detects nonspecific compounds in atherosclerotic lesions, and secondary prevention trials are unsuccessful. The evidence for an association between a pathogen and a chronic disease should be based on concordance of evidence arising from different approaches applied by different groups, at different times, in different places, and under different circumstances. None of these conditions have been fulfilled in the case of C. pneumoniae and atherosclerosis.¹

Citing the concluding paragraph of Margareta Ievens’ excellent review on Chlamydia pneumoniae and atherosclerosis, published in 2005 by the American Society of Micobiology (ASM) in their flagship journal for clinical microbiologists, the Journal of Clinical Microbiology, probably best summarizes the problems arising from diagnostic shortcomings of C pneumoniae, a microorganism that has been associated with well over 30 various diseases of markedly different pathologies and pathogenic mechanisms. Even though there is now "more evidence of no evidence" of the particular association on "C pneumoniae and atherosclerosis" than ever, every month articles continue to be published based on methods for which there is evidence that they are inadequate at various levels to define a patients’ C pneumoniae status. C pneumoniae serology is one of these methods.

In this issue of Stroke, Elkind et al² . . . [Full Text of this Article]

Related Article:

Seropositivity to Chlamydia pneumoniae Is Associated With Risk of First Ischemic Stroke

Mitchell S.V. Elkind, Maria Lucia C. Tondella, Daniel R. Feikin, Barry S. Fields, Shunichi Homma, and Marco R. Di Tullio
Stroke 2006 37: 790-795. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

				S. Bunk, I. Susnea, J. Rupp, J. T. Summersgill, M. Maass, W. Stegmann, A. Schrattenholz, A. Wendel, M. Przybylski, and C. Hermann Immunoproteomic Identification and Serological Responses to Novel Chlamydia pneumoniae Antigens That Are Associated with Persistent C. pneumoniae Infections J. Immunol., April 15, 2008; 180(8): 5490 - 5498. [Abstract] [Full Text] [PDF]

				S Alamowitch, J Labreuche, P-J Touboul, F Eb, P Amarenco, and for the GENIC Investigators Chlamydia pneumoniae seropositivity in aetiological subtypes of brain infarction and carotid atherosclerosis: a case control study J. Neurol. Neurosurg. Psychiatry, February 1, 2008; 79(2): 147 - 151. [Abstract] [Full Text] [PDF]