Related Experiment Videos
[Is infection a pathogenetic factor in coronary heart disease?]
1Institutt for eksperimentell medisinsk forskning Ullevål sykehus 0407 Oslo. hilchen.sommerschild@ioks.uio.no
Insights
Infection with Chlamydia pneumoniae and cytomegalovirus is associated with coronary artery disease, restenosis, and transplant atherosclerosis. Further research is needed to establish causality and explore antibiotic treatment benefits for cardiovascular events.
Area of Science:
- Cardiovascular Research
- Infectious Disease Epidemiology
- Pathogenesis of Atherosclerosis
Context:
- Established risk factors for coronary artery disease (CAD) are well-known.
- Emerging evidence suggests a potential role for infections in CAD development and progression.
- Clinical and animal studies investigate the link between pathogens and cardiovascular conditions.
Purpose:
- To provide an updated overview of clinical and experimental findings on the role of infection in CAD.
- To discuss potential cellular mechanisms involved in infection-induced atheromatosis.
- To evaluate the implications for coronary artery disease treatment strategies.
Summary:
- An association exists between coronary artery disease and Chlamydia pneumoniae infection.
- Cytomegalovirus infection is linked to restenosis and transplant atherosclerosis.
- Causal relationships are not fully established, and Helicobacter pylori shows no similar association.
Impact:
- Findings suggest a potential role for anti-infection strategies in secondary prevention of cardiovascular events.
- Identifying patient subgroups that may benefit from anti-infection treatment is crucial.
- Primary prevention of CAD should continue to focus on conventional risk factors.
Background:
Several wellknown risk-factors can contribute to the development of coronary artery disease. A relatively new question is whether infection is also involved in the pathogenesis. Acute and/or chronic infections might affect initiation, progression and instability in coronary artery disease, as well as enhance development of restenosis and transplant atherosclerosis. In clinical studies it is possible to measure the amount of antibodies in blood samples, detect infectious agents in atheromatous lesions, and evaluate potential effects of antibiotic treatment. In animal models it is possible to investigate whether a direct infection can induce atheromatosis.
Material And Methods:
The aim of this article is to give an updated overview of clinical and experimental results and discuss potential consequences for the treatment of coronary artery disease. Possible cellular mechanisms will be presented.
Results:
In conclusion, there is an association between coronary artery disease and infection with Chlamydia pneumoniae. Similar results are not obtained for infection with Helicobacter pylori. There is also an association between cytomegalovirus infection and development of restenosis and transplant atherosclerosis. However, a possible direct causal relationship is not fully established. Of special interest is whether antibiotic treatment can prevent acute cardiovascular events.
Interpretation:
Primary prevention must still be targeted at conventional risk factors. However, in secondary prevention it can be valuable to identify subgroups of patients which may benefit from anti-infection treatment.