In addition, the study has established that raised C-reactive protein levels in AAA patients are not related to either IgA or IgG antichlamydial antibodies. Acknowledgments The authors offer their sincerest thanks to Dr. and retards the growth of aneurysms [1]. Indomethacin, a nonspecific cyclooxygenase inhibitor, may attenuate aortic aneurysm growth by decreasing prostaglandin E2 and MMP expression via the COX2 isoform of cyclooxygenase [2]. Similarly, batimastat, a specific inhibitor of MMPs, may reduce elastin degradation in the aortas of rats given elastase, with reduced aneurysm growth and a reduction in the inflammatory response in the aortic wall [3]. In a case-control study, aneurysms expanded more slowly in patients treated with nonsteroidal anti-inflammatory drugs than in untreated patients [4]. Contamination with has been suggested to contribute to MMP production and aneurysm growth. In a double-blind randomised study, the eradication of chlamydia by the administration of doxycycline was found to reduce serum concentrations of C-reactive protein and aneurysm growth [5]. In a phase two study prolonged administration of doxycycline was shown to be safe and well tolerated by patients with small asymptomatic AAAs and was associated with a ST3932 progressive reduction in plasma MMP-9 levels [6]. These observations suggest that doxycycline eradicates contamination, reducing the rate of growth of aneurysms. The aim of this prospective case-control study was to assess the relationship between antibodies and the incidence of AAA in Rabbit polyclonal to AFF2 Northern Ireland and to determine the relationship, if any, between raised C-reactive protein levels and AAA in people with antichlamydial antibodies. 2. Patients and Methods 2.1. Patient Recruitment and Inclusion Criteria Ethical approval was obtained from the Northern Ireland Research Ethics Committee and Belfast City Hospital Trust ST3932 provided the clinical indemnity for this case control, prospective, single centre study. The ST3932 control (nAAA) group was recruited from those participants of the Northern Ireland AAA screening trial who experienced normal aortic diameters, that is, a longitudinal scan anterior-posterior diameter of less than 3.0?cm, as determined using the Sonosite 180 Plus system (Sonosite Inc., Bothwell, WA, USA). The patients in the AAA group were recruited from those attending the vascular outpatients clinic for routine follow-up of small aneurysms and those admitted in hospital for surgical treatment of ST3932 large AAA. Aneurysms were classed as small (3.0C4.4?cm), medium (4.5C5.5?cm), or large (>5.5?cm) according to the maximum diameter. Informed consent was obtained in writing from all participants. Separate blood samples were collected for enzyme-linked immunosorbent assay (ELISA) and C-reactive protein assay (CRP) in clot activator tubes (Vacutainer, “type”:”entrez-nucleotide”,”attrs”:”text”:”MD367954″,”term_id”:”1920494146″,”term_text”:”MD367954″MD367954, MidMeds Limited, Unit 71, Hillgrove Business Park, UK). A medical questionnaire was completed for all the recruited participants, including a detailed assessment of cardiovascular risk factors such as hypertension, diabetes mellitus, hypercholesterolemia, smoking status, coronary artery disease (CAD, defined as evidence of previous myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, or medical treatment for angina), cerebrovascular accident (CVA, defined as evidence of either a previous stroke or transient ischemic attack), and peripheral arterial disease (PAD, defined as an ankle brachial pressure index (ABPI) of <0.80 with or without symptoms of intermittent claudication). Other elements of the questionnaire included previous history of inflammatory disease, chronic obstructive airway disease (COAD), and family history of AAA. The questionnaire also included smoking history, differentiating current, former, and nonsmokers as layed out in the MONICA project by the World Health Organisation [7]. 2.2. Laboratory Analyses 2.2.1. ELISA Estimation of IgA and IgG Antibodies to were measured using ELISA packages (Ani Labsystems Ltd, Vantaa, Finland), following the manufacturer's instructions. All samples were analysed in duplicate and a mean of these values was recorded as the representative value. Absorbance was measured at 450?nm and the concentrations of enzyme immunounit (EIU) of IgA and IgG were recorded as negative (EIU <8), borderline (EIU 8C12), or positive (EIU >12) values. 2.2.2. C-Reactive Protein Assay The C-reactive protein concentrations were measured using the Tina-quant CRP latex particle-enhanced immunoturbidimetric assay (Roche Diagnostics Limited, Burgess Hill, West Sussex, United Kingdom). 2.3. Statistical Analysis The data ST3932 were analysed using SPSS 15.0.1 (SPSS Inc, Chicago, IL) for Windows (Microsoft Inc, Redmond, WA). Age and BMI were expressed as mean and standard deviation..