P279 Helicobacter pylori (Hp) DNA in carotid vessels (CV) and elevated CRP in serum of patients with carotid artery stenosis (CS) - a pilot study.
1M.Kowalski, 3U.Van Lengerich, 1R.Grove, 1N.Franz, 2P.C.Konturek, 1W.Rees, 4S.J.Konturek, 2E.G.Hahn, 1J.Thale, 3M.Clemens, 1H.Warnecke
1Dpt. of Cardiology and Cardiac Surgery, Heart Center Osnabrück-Bad Rothenfelde, Bad Rothenfelde; 2Dpt. of Medicine I, University Erlangen-Nürnberg, Erlangen; 3Dpt. of Surgery, Klinikum Osnabrück, Osnabrück; 4Institute of Physiology, Jagiellonen-University, Cracow, PL.

Recent seroepidemiologic studies show that it may be reasonable to suppose that Hp is associated with atherosclerosis. However, it is unclear if such an association exists and if so whether it is due to the chronic infection (elevated CRP with oxygen stress) or is to be seen as a result of direct action of Hp on endothel. The aim of this pilot study was: 1. to evaluate, whether Hp can be detected in CV in patients with carotid artery stenosis (CS) and 2. to control the serum CRP-level.

Methods: 15 patients with CS (12 male and 3 female, mean age 65+11 years) were included in the pilot-study. All patients underwent carotid artery thrombendarterectomy (TEA). In addition polymerase chain reaction (PCR) for detection of HP-DNA in biopsy specimen were obtained from carotid vessels during TEA. DNA was tested by PCR for presence of genomic 16S RNA of Hp. Amplified products were confirmed by sequence analysis. All patients were also tested for IgG-antibodies against Hp and for CRP-level in serum before TEA.

Results: 10 patients showed Hp-IgG-antibodies, 5 not.

Hp-DNA was detected in 6 (all Hp-IgG positive) out of 15 patients (40%). All Hp-IgG positive and 2 Hp-IgG negative patients showed elevated CRP-levels (0.84 ± 9 mg%).

Conclusion: The detection of Hp DNA in carotid arteries and elevated level of serum CRP in all Hp-positive patients suggests that Hp may be involved in the pathogenesis of carotid atherosclerosis (chronic infection and direct action of endothel).