Giant cell arteritis is an inflammation of the medium and
large-sized arteries, mainly of the outermost of their three layers,
the adventitia. It is known to be associated with previous upper
respiratory tract symptoms. The occurrence of cases is often clustered
in certain time periods and geographic locations. It is primarily a
disease of the elderly, and is more common in women than in men. Fever
of unknown origin is one of the symptoms. Along with polymyalgia
rheumatica, a related clinical syndrome, it
is strongly associated with DR4 positivity. (187360 TEMPORAL ARTERITIS
Alternative titles; symbols GIANT CELL ARTERITIS; GCA; CRANIAL
ARTERITIS; POLYMYALGIA RHEUMATICA. OMIM; HLA-DRB1 allele distribution
in polymyalgia rheumatica and giant cell arteritis: influence on
clinical subgroups and prognosis. VM Martínez-Taboda, MJ
Bartolome, M Lopez-Hoyos, R Blanco, C Mata, J Calvo, A Corrales, V
Rodriguez-Valverde. Semin Arthritis Rheum 2004 Aug;34(1):454-464.)
Detection of Chlamydia pneumoniae in giant cell vasculitis and
correlation with the topographic arrangement of tissue-infiltrating
dendritic cells. AD Wagner, HC Gerard, T Fresemann, WA Schmidt, E
Gromnica-Ihle, AP Hudson, H Zeidler. Arthritis and Rheumatism 2000
Jul;43(7):1543-1551. 8 of 9 GCA patients were PCR-positive for
Chlamydia
pneumoniae, while the only one of nine controls who was positive for CP
had respiratory symptoms. In some of the tissue specimens, CP was found
outside of cells, "possibly suggesting that the organism was viable and
undergoing active vegetative growth in temporal artery tissues in GCA
patients."
Temporal arteritis associated with Chlamydia pneumoniae DNA detected in an artery specimen. G Haugeberg, R Bie, SA Nordbo. J Rheumatol 2001 Jul;28(7):1738-1739. Letter; no abstract.
Haugeberg - J Rheumatol 2001 abstract / PubMedIs giant cell arteritis an infectious disease? Biological and
epidemiological evidence. P Duhaut, S Bosshard, JP Ducroix. Presse Med
2004 Nov 6;33(19 Pt 2):1403-1408. Review.
Infection and temporal arteritis: a PCR-based study to detect
pathogens in temporal artery biopsy specimens. RJ Cooper, S D'Arcy, M
Kirby, M Al-Buhtori, MJ Rahman, L Proctor, RE Bonshek. J Med Virol 2008
Mar;80(3):501-505. "Samples from 37 temporal artery biopsies with
histological evidence of arteritis and 66 samples from histologically
negative temporal artery biopsies, all from different patients, were
negative for C. pneumoniae, HSV, VZV, EBV, and HHV7 DNA. Two of the 37
histologically positive specimens were positive for HHV6, another two
for CMV and a further two for parvovirus B19 DNA. Parvovirus B19 DNA
was also detected in five histologically negative biopsies, one
positive for HCMV DNA and a further one was positive for HHV6 DNA.
There is no statistically significant difference to the presence of
virus DNA in the two types of specimens (P = 0.538)."
Serum levels of antibodies to Chlamydia pneumoniae and human HSP60
in giant cell arteritis patients. M López-Hoyos, L Alvarez, M
Ruiz Soto, R Blanco, M José Bartolomé, VM
Martínez-Taboada. Clin Exp Rheumatol 2008
Nov-Dec;26(6):1107-1110. "17 GCA patients, 39 polymyalgia rheumatica
(PMR) patients and 23 age-matched healthy subjects.RESULTS:Serum IgG
anti-hHSP60, but not anti-C. pneumoniae, antibodies were significantly
increased in GCA patients in comparison with PMR patients or healthy
controls. After steroid therapy, both anti-hHSP60 and -C. pneumoniae
antibodies decreased significantly in both groups of patients."
Acute Chlamydia pneumoniae infection in the pathogenesis of
autoimmune diseases. M Fujita, S Hatachi, M Yagita. Lupus 2009
Feb;18(2):164-168. 82 patients with several autoimmune diseases and 70
controls. "Chlamydia pneumoniae IgM positive cases were more frequent
among the patients with rheumatoid arthritis (RA; 30%, P < 0.05),
systemic lupus erythematosus (SLE; 28.0%, P < 0.05),
dermatomyositis/polymyositis (23%, NS), myeloperoxidase-antineutrophil
cytoplasmic autoantibody (MPO-ANCA)-associated vasculitis (33%, NS),
adult onset of Still's disease (29%, NS) and giant cell
arteritis/Takayasu arteritis (50%, NS) than among the controls. This
positive frequency was statistically significant in RA and SLE."
No Correlation Between Giant Cell Arteritis and Chlamydia pneumoniae
Infection: Investigation of 189 Patients With Standard and Improved PCR
Methods. F Njau, T Ness, U Wittkop, T Pancratz, M Eickhoff, AP Hudson,
H Haller, AD Wagner. J Clin Microbiol 2009 Apr 22. [Epub ahead of
print]. "189 temporal artery biopsies from giant cell arteritis (GCA)
patients were investigated using sensitive PCR targeting Chlamydia
pneumoniae. Chlamydial DNA was detected in 17 samples, 11/17 were
positive for chlamydial antigen."
The Autoimmunity Research Foundation conducts research on the role of C. pneunoniae in sarcoidosis. Trevor G. Marshall, the Chairman, says that no single antibiotic among those cited for use against C. pneumoniae (Rifampin, Azithromycin, Gatifloxacin, and Clarithromycin) has any effect against these intra-phagocytic bacteria. (Rapid Response. Intra-mononuclear-cell Bacteria are Key to much Chronic Disease. GT Marshall. BMJ 2005 Aug. 12).
About Us / Autoimmunity Research FoundationDetection of serum antibodies to Chlamydia pneumoniae in patients with endogenous uveitis and acute conjunctivitis. K Numazaki, S Chiba, K Aoki, K Suzuki, S Ohno. Clin Infect Dis 1997 Oct;25:928-929. "We determined the titer of serum antibodies to C. pneumoniae for 48 adult patients with endogenous uveitis (29 had sarcoidosis, 10 had Behcet's disease, and 9 had Vogt-Kyanagi disease) and for 28 adult patients with acute conjunctivitis. We also determined the titer of serum antibodies to C. pneumoniae in 30 healthy adults who served as controls... Of 30 healthy adults, IgG antibodies to C. pneumoniae were detected in 17 (56.7%), and IgA antibodies were detected in 15 (50.0%). IgM antibodies to C. pneumoniae were detected in 6 (20%) adults. Of 29 patients with sarcoidosis, IgG antibodies to C. pneumoniae were detected in 21 (72.4%), and IgA antibodies were detected in 15 (51.7%); IgM antibodies to C. pneumoniae were detected in 17 (58.6%) patients. IgG antibodies to C. pneumoniae were detected in seven (70%) of 10 patients with Behcet's disease and in three (33%) of nine patients with Vogt-Koyanagi disease. Neither IgA nor IgM antibodies to C. pneumoniae were detected in the patients with Behcet's or Vogt-Koyanagi disease. Of 28 patients with acute conjunctivitis, IgG antibodies to C. pneumoniae were detected in 16 (57.1%); in 2 (7.1%) of these patients, IgA and IgM antibodies to C. pneumoniae were detected. The prevalence of serum IgA and IgM antibodies to C. pneumoniae in patients with endogenous uveitis associated with sarcoidosis was significantly higher than that in patients with other endogenous uveitis (P< 0.01; t-test; Welch's modification).
Numazaki - Clin Infect Dis 1997 (no abstract) / PubMedChlamydial antibodies in patients with previous acute anterior uveitis. M Huhtinen, M Puolakkainen, K Laasila, M Sarvas, A Karma, M Leirisalo-Repo. Invest Ophthalmol Vis Sci 2001 Jul;42(8):1816-1819. IgA antibodies to C pneumoniae heat shock protein 60 in patients vs controls, P = 0.0001.
Huhtinen - Invest Ophthalmol Vis Sci 2001 abstract / PubMedcast 05-24-09