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01.01.2011 | Original Article

CagA-Positive Helicobacter pylori Strains Enhanced Coronary Atherosclerosis by Increasing Serum OxLDL and HsCRP in Patients with Coronary Heart Disease

verfasst von: Bingsheng Huang, Ying Chen, Qiang Xie, Guixiong Lin, Yuyan Wu, Yanlin Feng, Jingcao Li, Yufeng Zhuo, Peng Zhang

Erschienen in: Digestive Diseases and Sciences | Ausgabe 1/2011

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Abstract

Background

The role of infection in the pathogenesis of atherosclerosis is still a matter of debate.

Aims

This study aimed to investigate the effect of CagA-positive Helicobacter pylori (H. pylori) strains infection on coronary atherosclerosis in patients with coronary heart disease and to elucidate how cytotoxin-associated gene A (CagA)-positive H. pylori strains infections were involved in coronary heart disease by examining the levels of serum lipid, high-sensitivity C-reactive protein (hsCRP) and oxidized low-density protein (oxLDL).

Methods

Recruited for this study were 159 patients with coronary heart disease. The severity of coronary heart disease was estimated by calculating the Gensini score. Serum oxLDL and hsCRP were examined in all subjects. Current H. pylori infection was determined in all participants by means of a modified (13C) urea breath test (>200 dpm classified as positive). IgG antibodies against CagA protein were analyzed by enzyme immunoassays. Antibody titers against CagA (≥8 U/ml) were classified as positive. All subjects were divided into three groups, including an uninfected group (n = 30), an H. pylori ⁺CagA⁻ group (n = 69), and an H. pylori ⁺CagA⁺ group (n = 60).

Results

Significant differences were found among the three groups in levels of total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, serum hsCRP, oxLDL, and severity of coronary atherosclerosis (p < 0.05). The levels of total cholesterol, LDL, apolipoprotein B, serum hsCRP, oxLDL were significantly elevated and the severity of coronary atherosclerosis was significantly increased in H. pylori ⁺CagA⁺ group (p < 0.05).

Conclusions

More serious coronary atherosclerosis was observed in CHD patients with H. pylori ⁺CagA⁺ infection. H. pylori ⁺CagA⁺ infection might be involved in coronary atherosclerosis by modifying serum lipids, enhancing LDL oxidation, and activating the inflammatory responses.

Sanders MK, Peura DA. Helicobacter pylori-associated diseases. Curr Gastroenterol Rep. 2002;4:448–454.CrossRefPubMed

Gasbarrini A, Franceschi F, Cammarota G, Pola P, Gasbarrini G. Vascular and immunological disorders associated with Helicobacter pylori infection. Ital J Gastroenterol Hepatol. 1998;30:115–118.PubMed

Gasbarrini A, De Luca A, Fiore G, et al. Beneficial effects of Helicobacter pylori eradication on migraine. Hepatogastroenterology. 1998;45:765–770.PubMed

Gasbarrini A, Serricchio M, Tondi P, et al. Raynaud’s phenomenon and Helicobacter pylori infection. Int J Angiol. 1998;7:307–309.CrossRefPubMed

Szklo M, Ding J, Tsai MY, et al. Individual pathogens, pathogen burden and markers of subclinical atherosclerosis: the Multi-Ethnic Study of Atherosclerosis. J Cardiovasc Med. 2009;10:747–751.CrossRef

Kaklikkaya I, Kaklikkaya N, Buruk K, et al. Investigation of Chlamydia pneumoniae DNA, chlamydial lipopolisaccharide antigens, and Helicobacter pylori DNA in atherosclerotic plaques of patients with aortoiliac occlusive disease. Cardiovasc Pathol. 2006;15:105–109.CrossRefPubMed

Ozdogru I, Kalay N, Dogan A, et al. The relationship between Helicobacter pylori IgG titre and coronary atherosclerosis. Acta Cardiol. 2007;62:501–505.CrossRefPubMed

Chimienti G, Russo F, Lamanuzzi BL, et al. Helicobacter pylori is associated with modified lipid profile: impact on Lipoprotein(a). Clin Biochem. 2003;36:359–365.CrossRefPubMed

Niemelä S, Karttunen T, Korhonen T, et al. Could Helicobacter pylori infection increase the risk of coronary heart disease by modifying serum lipid concentrations? Heart. 1996;75:573–575.CrossRefPubMed

10.

Hoffmeister A, Rothenbacher D, Bode G, et al. Current infection with Helicobacter pylori, but not seropositivity to Chlamydia pneumoniae or Cytomegalovirus, is associated with an atherogenic, modified lipid profile. Arterioscler Thromb VascBiol. 2001;21:427–432.

11.

Crabtree JE, Shallcross TM, Heatley RV. Mucosal tumour necrosis factor alpha and interleukin-6 in patients with Helicobacter pylori associated gastritis. Gut. 1991;32(10):1473–1477.CrossRefPubMed

12.

Zito F, Di Castelnuovo A. Helicobacter pylori infection and the risk of myocardial infarction, role of fibrinogen and its genetic control. Thromb Haemost. 1999;82(1):14–18.PubMed

13.

Kayo S, Ohsawa M, Ehara S, et al. Oxidized low-density lipoprotein levels circulating in plasma and deposited in the tissues: comparison between Helicobacter pylori-associated gastritis and acute myocardial infarction. Am Heart J. 2004;148:818–825.CrossRefPubMed

14.

Mayr M, Kiechl S, Tsimikas S, et al. Oxidized low-density lipoprotein autoantibodies, chronic infections, and carotid atherosclerosis in a population-based study. J Am Coll Cardiol. 2006;47:2436–2443.CrossRefPubMed

15.

Mayr M, Kiechl S, Willeit J, Wick G, Xu Q. Infections, immunity, and atherosclerosis: associations of antibodies to Chlamydia pneumoniae, Helicobacter pylori, and Cytomegalovirus with immune reactions to heat-shock protein 60 and carotid or femoral atherosclerosis. Circulation. 2000;102:833–839.PubMed

16.

Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol. 1983;51:606.CrossRefPubMed

17.

Itabe H, Yamamoto H, Imanaka T, et al. Sensitive detection of oxidatively modified low-density lipoprotein using a monoclonal antibody. J Lipid Res. 1996;37:45–53.PubMed

18.

Adiloglu AK, Ocal A, Can R, Duver H, Yavuz T, Aridogan BC. Detection of Helicobacter pylori and Chlamydia pneumoniae DNA in human coronary arteries and evaluation of the results with serologic evidence of inflammation. Saudi Med J. 2005;26:1068–1074.PubMed

19.

Kowalski M, Pawlik M, Konturek JW, Konturek SJ. Helicobacter pylori infection in coronary artery disease. J Physiol Pharmol. 2006;57:101–111.

20.

Niu YH, Xu CF, Shi JH, Ge JB. Relationship between infection burden and atherosclerosis and plaque feature. Zhonghua Xin Xue Guan Bing Za Zhi. 2005;33:303–306.PubMed

21.

Michael R, Armin J, Buggle F, et al. Association between cerebral ischemia and cytotoxin-associated gene-a-bearing strains of Helicobacter pylori. Stroke. 2004;35:1800.CrossRef

22.

Zhang S, Guo Y, Ma Y, Teng Y. Cytotoxin-associated gene-A-seropositive virulent strains of Helicobacter pylori and atherosclerotic diseases: a systematic review. Chin Med J. 2008;121:946–951.PubMed

23.

Mayr M, Kiechl S, Mendall MA, Willeit J, Wick G, Xu QB. Increased risk of atherosclerosis is confined to CagA-positive Helicobacter pylori strains prospective results from the Bruneck study. Stroke. 2003;34:610–615.CrossRefPubMed

24.

Danesh J, Collins R, Peto R. Chronic infections and coronary heart disease: is there a link? Lancet. 1997;350:430–436.CrossRefPubMed

25.

Libby P, Egan D, Skarlatos S. Roles of infectious agents in atherosclerosis and restenosis: an assessment of the evidence and need for future research. Circulation. 1997;96:4095–4103.PubMed

26.

Mehta JL, Saldeen TGP, Rand K. Interactive role of infection, inflammation and traditional risk factors in atherosclerosis and coronary artery disease. J Am Coll Cardiol. 1998;31:1217–1225.CrossRefPubMed

27.

Covacci A, Censini S, Bugnoli M, et al. Molecular characterization of the 128-kDa immunodominant antigen of Helicobacter pylori associated with cytotoxicity and duodenal ulcer. Proc Natl Acad Sci USA. 1993;90:5791–5795.CrossRefPubMed

28.

Oshima T, Ozono R, Yano Y, et al. Association of Helicobacter pylori infection with systemic inflammation and endothelial dysfunction in healthy male subjects. Am Coll Cardiol. 2005;45:1219–1222.CrossRef

29.

Saijo Y, Utsugi M, Yoshioka E, et al. Relationship of Helicobacter pylori infection to arterial stiffness in Japanese subjects. Hypertens Res. 2005;28:283–292.CrossRefPubMed

30.

Diomedi M, Pietroiusti A, Silvestrini M, et al. CagA positive Helicobacter pylori strains may influence the natural history of atherosclerotic stroke. Neurology. 2004;63:800–804.PubMed

31.

Kiechl S, Egger G, Mayr M, et al. Chronic infections and the risk of carotid atherosclerosis: prospective results from a large population study. Circulation. 2001;103:1064–1070.PubMed

32.

Zhu J, Quyyumi AA, Norman JE, Csako G, Epstein SE. Cytomegalovirus in the pathogenesis of atherosclerosis: the role of inflammation as reflected by elevated C-reactive protein levels. J Am Coll Cardiol. 1999;34:1738–1743.CrossRefPubMed

33.

Blake GJ, Ridker PM. Novel clinical markers of vascular wall inflammation. Circ Res. 2001;89:763–771.CrossRefPubMed

34.

Kiechl S, Lorenz E, Reindl M, et al. Toll-like receptor 4 polymorphisms and atherogenesis. N Engl J Med. 2002;347:185–192.CrossRefPubMed

35.

Steinberg D, Parthasarathy S, Carew TE, Khoo JC, Witztum JL. Beyond cholesterol: modifications of low-density lipoprotein that increase its atherogenicity. N Engl J Med. 1989;320:915–924.CrossRefPubMed

36.

Steinberg D, Witztum JL. Lipoproteins and atherogenesis: current concepts. JAMA. 1990;264:3047–3052.CrossRefPubMed

37.

Steinberg D. Low-density lipoprotein oxidation and its pathobiological significance. J Biol Chem. 1997;272:20963–20966.CrossRefPubMed

38.

Stemme S, Faber B, Holm J, Wiklund O, Witztum JL, Hansson GK. T lymphocytes from human atherosclerotic plaques recognize oxidized low-density lipoprotein. Proc Natl Acad Sci USA. 1995;92:3893–3897.CrossRefPubMed

39.

Smith C, Mitchinson MJ, Aruoma OI, Halliwell B. Stimulation of lipid peroxidation and hydroxyl-radical generation by the contents of human atherosclerotic lesions. Biochem J. 1992;286:901–905.PubMed

40.

Ehara S, Ueda M, Naruko T, et al. Elevated levels of oxidized low density lipoprotein show a positive relationship with severity of acute coronary syndromes. Circulation. 2001;103:1955–1960.PubMed

41.

Naruko T, Ueda M, Haze K, et al. Neutrophil infiltration of culprit lesions in acute coronary syndromes. Circulation. 2002;106:2894–2900.CrossRefPubMed

42.

Azumi H, Inoue N, Ohashi Y, et al. Superoxide generation in directional coronary atherectomy specimens of patients with angina pectoris: important role of NAD(P)H oxidase. Arterioscler Thromb Vasc Biol. 2002;22:1838–1844.CrossRefPubMed

43.

Huang B, Dong Y, Mai W, Li Y. Effect of Chlamydia pneumoniae infection and hyperlipidaemia on the expression of PPARgamma, P50 and c-Fos in aortic endothelial cells in C57bL/6 J mice. Acta Cardiol. 2005;60(1):43–49.CrossRefPubMed

Titel: CagA-Positive Helicobacter pylori Strains Enhanced Coronary Atherosclerosis by Increasing Serum OxLDL and HsCRP in Patients with Coronary Heart Disease
verfasst von: Bingsheng Huang
Ying Chen
Qiang Xie
Guixiong Lin
Yuyan Wu
Yanlin Feng
Jingcao Li
Yufeng Zhuo
Peng Zhang
Publikationsdatum: 01.01.2011
Verlag: Springer US
Erschienen in: Digestive Diseases and Sciences / Ausgabe 1/2011
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI: https://doi.org/10.1007/s10620-010-1274-6

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Abstract

Background

Aims

Methods

Results

Conclusions

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