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[Persistence of Chlamydia pneumoniae in human arteriosclerotic plaque substance. Evidence and consequences]
1Institut für Medizinische Mikrobiologie und Hygiene, Medizinische Universität zu Lübeck. maass@hygiene.mu-luebeck.de
Insights
Chlamydia pneumoniae infection is linked to increased coronary artery disease risk. Further research is needed to confirm its role in atherosclerosis and guide antichlamydial treatment for heart disease.
Area of Science:
- Cardiovascular Science
- Infectious Disease
Context:
- Chlamydia pneumoniae is an obligate intracellular bacterium.
- Atherosclerosis is a major cause of coronary artery disease (CAD) and myocardial infarction (MI).
- Serological evidence suggests a correlation between C. pneumoniae infection and increased risk of CAD and MI.
Purpose:
- To explore the potential role of Chlamydia pneumoniae in the pathogenesis of atherosclerosis.
- To evaluate the current evidence linking C. pneumoniae to cardiovascular disease.
- To identify gaps in knowledge and research needs regarding C. pneumoniae and atherosclerosis.
Summary:
- The presence of C. pneumoniae structures and viable bacteria in atherosclerotic plaques supports its potential involvement.
- Initial studies have explored antimicrobial therapy for coronary heart disease, but experimental proof of an etiological role is lacking.
- Challenges include the absence of a suitable animal model and genetic recombination system, and a lack of reliable markers for endovascular infection risk.
Impact:
- Understanding Chlamydial contribution to atherosclerosis could revolutionize clinical practice for a leading cause of death.
- Antichlamydial treatment for coronary heart disease is currently only justified within well-controlled clinical trials.
- Further research is crucial to determine if C. pneumoniae initiates, promotes, or merely colonizes atherosclerotic lesions.
Abstract:
The obligate intracellular bacterium Chlamydia pneumoniae has recently been implicated in the pathogenesis of atherosclerosis. Serological response to Chlamydia pneumoniae statistically indicates an increased risk of coronary artery disease and myocardial infarction. This surprising relation is corroborated by the presence of chlamydial structures and even viable Chlamydia pneumoniae in atherosclerotic plaques. These findings have already resulted in initial studies on the potential benefit of antimicrobial therapy in coronary heart disease. However, experimental proof of an etiological role of Chlamydia pneumoniae in arteriosclerosis has not yet been accomplished since a well established animal model and a system of genetic recombination are not yet available. In addition, clinical evaluation of patients is complicated by the lack of a useful parameter to indicate the risk of endovascular infection. Whether chlamydiae initiate atherosclerotic injury. facilitate progression of existing plaques, or merely colonize the lesions is therefore not known. Chlamydial contribution to the development of atherosclerosis is a fascinating hypothesis that may initiate a radical change of clinical practice for one of the leading causes of death. At the current state of scientific knowledge, however, an experimental antichlamydial treatment in coronary heart disease may only be justified in well controlled clinical trials.