Relation of C pneumoniae antibodies to ischaemic heart disease

BMJ 1999;319:1575 ( 11 December )

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Relation of C pneumoniae antibodies to ischaemic heart disease

Why were samples weakly positive for IgG antibodies not tested for IgA antibodies?

Finnish study finds significant association between raised IgG, but not IgA, titres and mortality

Why were samples weakly positive for IgG antibodies not tested for IgA antibodies?

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EDITOR $---$ The relation of Chlamydia pneumoniae antibodies to ischaemic heart disease reported by Strachan et al, and the commentaryon the paper, deserve comment.¹ An association is reportedbetween IgA antibody at the start of the study and prevalent ischaemicheart disease or subsequent death due to ischaemic heart disease.Presumably, serum samples with an IgG antibody titre of <1 in16 were not tested for IgA antibody because it was thought thatIgA antibody would not exist. Why, however, were 310 samples thatwere weakly positive for IgG antibodies not tested for IgA antibodies?Surely some of these could have been weakly positive for IgA antibodiesat 1 in 16 and so have influenced the interpretation ofresults?

Persistent IgA antibody is thought to indicate a chronic infection, as is persistent IgG antibody. Conceptually, therefore,it is difficult to understand why significance should apply apparentlyonly to the presence of IgA antibodies, . . . [Full text of this article]

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Relation of Chlamydia pneumoniae serology to mortality and incidence of ischaemic heart disease over 13 years in the Caerphilly prospective heart disease study • Commentary: Chlamydia pneumoniae infection and ischaemic heart disease: David P Strachan, David Carrington, Michael A Mendall, Lydia Ballam, Julia Morris, Barbara K Butland, Peter M Sweetnam, Peter C Elwood, and Robert R West
BMJ 1999 318: 1035-1040. [Abstract] [Full Text] [PDF]

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Wald, N J, Law, M R, Morris, J K, Zhou, X, Wong, Y, Ward, M E (2000). Chlamydia pneumoniae infection and mortality from ischaemic heart disease: large prospective study. BMJ 321: 204-207 [Abstract] [Full text]