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Chlamydia pneumoniae and vascular disease: an update
Firas F Mussa1, Hong Chai, Xinwen Wang
1Molecular Surgeon Research Center, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
Journal of Vascular Surgery
|June 13, 2006
Summary
Chlamydia pneumoniae infection is common and linked to atherosclerosis and heart disease. Antibiotic trials show mixed results, suggesting a complex role in cardiovascular disease development.
Area of Science:
- Cardiovascular Science
- Infectious Disease Epidemiology
- Microbiology
Background:
- Chlamydia pneumoniae (C pneumoniae) infection is prevalent and increases with age.
- C pneumoniae is strongly associated with various forms of atherosclerosis, including coronary artery disease.
- Evidence includes seroepidemiologic studies and direct detection in atherosclerotic lesions.
Purpose of the Study:
- To review the role of C pneumoniae in atherogenesis.
- To analyze recent antibiotic treatment trials, animal studies, and in vitro research.
- To examine the potential role of Chlamydia heat shock protein.
Main Methods:
- Review of seroepidemiologic studies.
- Direct detection of C pneumoniae in atherosclerotic lesions (immunohistochemistry, PCR, electron microscopy, tissue culture).
- Analysis of animal models of atherosclerosis and human antibiotic trials.
Main Results:
- C pneumoniae infects macrophages, smooth muscle cells, and endothelial cells.
- Infection promotes proinflammatory cytokine secretion and foam cell formation.
- Recent large antibiotic trials have yielded complex results regarding secondary prevention.
Conclusions:
- C pneumoniae plays a significant role in atherogenesis.
- The effectiveness of antibiotic therapy for secondary prevention requires further investigation.
- Chlamydia heat shock protein may mediate C pneumoniae's harmful effects on the vasculature.