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Chronic obstructive pulmonary disease (COPD) is a possible risk factor for cardiovascular disease. The association of COPD with the pathogenicity of infection with  Chlamydia pneumoniae  and  Mycoplasma pneumoniae  is controversial. We conducted a cross-sectional study to clarify the association between atypical  pneumoniae  seropositivity and COPD in a general population. We also investigated genetic polymorphisms conferring susceptibility to a  pneumonia  titer.  The study included 9040 Japanese subjects (54 ± 13 years). COPD was defined as a ratio of forced expiratory volume in 1 second to forced vital capacity of less than 70%. Serum levels of IgA and IgG antibodies to  C pneumoniae  were determined using an enzyme-linked immunoassay, and  M pneumoniae  seropositivity was assessed by a particle agglutination test.  Subjects seropositive for  C pneumoniae  (26.1%) had a higher prevalence of COPD (seropositive, 5.8%; seronegative, 3.1%;  P  < 0.001) after adjustment for age, sex, height, weight, and smoking status. The association between  M pneumoniae  seropositivity (20.4%) and COPD was also significant in covariate-adjusted analysis ( P  < 0.001). A genome-wide association analysis of the  C pneumoniae  IgA index identified a susceptible genotype (rs17634369) near the  IKZF1  gene, and the seropositive rate of  C pneumoniae  significantly differed among genotypes (AA, 22.5; AG, 25.3; GG, 29.7%,  P  < 0.001). On multiple regression analysis, seropositivity for both  C pneumoniae  (odds ratio = 1.41,  P  = 0.004) and  M pneumoniae  (odds ratio = 1.60,  P  = 0.002) was an independent determinant for COPD, while no direct association was found with the rs17634369 genotype.  Seropositivity for both  C pneumoniae  and  M pneumoniae  is an independent risk factor for COPD in the general population.

medicine

Relationship Among Chlamydia and Mycoplasma Pneumoniae Seropositivity, IKZF1 Genotype and Chronic Obstructive Pulmonary Disease in A General Japanese Population