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[Atherosclerosis as an infectious disease]
1Academisch Ziekenhuis, afd. Inwendige Geneeskunde, Utrecht.
Abstract:
According to several published studies micro-organisms may be involved in atherogenesis. An association is described between cytomegalovirus or Chlamydia pneumoniae and an increased risk of vascular events. The micro-organisms are able to infect endothelial cells and smooth muscle cells in vivo and in vitro, evoking to pathophysiological reactions of these cells which may lead to atherosclerosis, arterial thrombosis and plaque rupture. In two small secondary prevention trials, macrolide treatment proved successful in preventing second myocardial infarctions. At this moment, however, it is too early for treatment with antimicrobial agents to prevent vascular diseases in daily clinical practice.
Insights
Certain microorganisms like cytomegalovirus and Chlamydia pneumoniae may contribute to atherosclerosis. While antimicrobial treatment showed promise in small trials, it is not yet recommended for preventing vascular diseases in clinical practice.
Area of Science:
- Microbiology
- Cardiovascular Science
- Pathology
Context:
- Emerging evidence suggests a role for microbial infections in the development of atherosclerosis.
- Specific pathogens, including cytomegalovirus and Chlamydia pneumoniae, have been linked to an elevated risk of vascular events.
Purpose:
- To explore the potential involvement of microorganisms in atherogenesis.
- To review the pathophysiological mechanisms by which microbes may contribute to atherosclerosis.
- To assess the preliminary efficacy of antimicrobial therapies in secondary prevention of cardiovascular events.
Summary:
- Microorganisms can infect endothelial and smooth muscle cells, triggering reactions that may lead to atherosclerosis, arterial thrombosis, and plaque rupture.
- Two small secondary prevention trials indicated that macrolide treatment was successful in preventing recurrent myocardial infarctions.
Impact:
- Highlights the potential link between infectious agents and cardiovascular disease, opening avenues for novel therapeutic strategies.
- Suggests that while promising, antimicrobial treatments require further investigation before widespread clinical application for vascular disease prevention.