%0 Journal Article
%T The influence of persistent pathogens on circulating levels of inflammatory markers: a cross-sectional analysis from the Multi-Ethnic Study of Atherosclerosis
%A Aydin Nazmi
%A Ana V Diez-Roux
%A Nancy S Jenny
%A Michael Y Tsai
%A Moyses Szklo
%A Allison E Aiello
%J BMC Public Health
%D 2010
%I BioMed Central
%R 10.1186/1471-2458-10-706
%X Using data from a subsample of the Multi-Ethnic Study of Atherosclerosis, we examined circulating levels of interleukin-6 (IL-6), C-reactive protein (CRP) and fibrinogen in relation to five common persistent pathogens: cytomegalovirus, herpes simplex virus-1, Hepatitis A virus, Helicobacter pylori and Chlamydia pneumoniae. We tested the hypothesis that the number of seropositive pathogens (based on conventional cut-off points) would not be as sensitive a marker of inflammation as immune response measured by antibody levels to pathogens.High antibody response to multiple pathogens showed graded and significant associations with IL-6 (p < 0.001), CRP (p = 0.04) and fibrinogen (p = 0.001), whereas seropositive pathogen burden did not. In multiple linear regression models, high antibody response to multiple pathogens maintained a positive association only with IL-6 (4.4% per pathogen exhibiting high antibody response, 95% CI 0.0-8.9).High antibody response to pathogens was a more consistent marker of inflammatory outcomes compared to seropositivity alone and high antibody response to multiple pathogens was a stronger marker compared to any single pathogen.Persistent pathogens, those acquired early in life and maintained without causing obvious illness, are implicated in cardiovascular disease etiology. Numerous studies have suggested that persistent viruses such as cytomegalovirus (CMV), herpes simplex virus-1 (HSV), Hepatitis A virus (HAV) and bacterial pathogens such as Helicobacter pylori (H. pylori) and Chlamydia pneumoniae (C. pneumoniae) are associated with cardiovascular disease [1-4], although some studies do not support a significant relationship [5-7]. Effects of multiple infectious agents may be synergistic, and some authors suggest that pathogen burden (total number of pathogens) has a greater impact on cardiovascular risk than isolated pathogens [4,8,9]. It is hypothesized that the association between pathogens and cardiovascular disease is, in part, mediat
%U http://www.biomedcentral.com/1471-2458/10/706