nemoci-sympt/BAKTERIALNI-INFEKCE/chlamydie/symptomy-a-asociovana-onemocneni/makularni-degenerace

Makulární degenerace

• C. pneumonia exposure has been suggested to be associated with AMD21,22,23. Kalayoglu et al reported that C. pneumoniae DNA was identified in surgically removed neovascular tissue from eyes with AMD27, but other studies, including a population-based study examining 3,654 adults, failed to find any association between C. pneumoniae antibody titers and AMD, thereby generating controversy28,29,30,31. However, in the present study assessing 60+ factors in 4,000+ adults, we found a strong effect of C. pneumoniae infection on drusen. To date, there is a consensus that the CFH gene is associated with advanced AMD7,20. CFH is known as the main soluble inhibitor of the alternative pathway, which prevents progression of the cascade by binding and inactivating complement component C3b32. Several complement system factors, their activators, and complement regulatory proteins were identified as cardinal constituents of drusen8,33 although the association between the CFH and early AMD remains controversial34,35. C. pneumoniae activates the alternative complement pathway or induces a chronic inflammatory state, which might contribute to the pathogenesis of AMD21,22,23. The present study, which showed a significant relationship between C. pneumoniae and the development of drusen, would indicate the significant role of the complement pathway in the inflammatory process with the disease development. On the other hand, we did not find strong associations between CFH genotypes and drusen. Taken together, our result would suggest that the activation of the alternative complement pathway by C. pneumoniae might be more important than that by CFH gene variation in the early stages of AMD in Asians.