クライミジア肺炎は,心臓血管疾患の新興リスク因子である

Murat V Kalayoglu¹, Peter Libby, Gerald I Byrne

¹Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Mass, USA. gbyrne@utmem.edu

JAMA

|December 4, 2002

まとめ

クラミジア肺炎感染症は,慢性炎症性疾患である動脈硬化症と関連しています. 症状の発症に不可欠ではないが,心血管疾患のリスク因子として修正可能である.

科学分野:

心血管疾患に関する研究
感染症疫学感染症疫学
動脈硬化症の病原性について

背景:

動脈硬化症は,慢性炎症性疾患としてますます認識されています.
感染症剤は,アテロゲネシスにおける潜在的な役割について調査されています.
クラミジア肺炎感染症は,治療可能な危険因子としての潜在的可能性のために,重要な焦点です.

研究の目的:

クラミジア肺炎と動脈硬化症との関連に関する既存の証拠をレビューする.
心血管疾患におけるC.pneumoniaeの役割に関するさまざまな研究タイプの発見を統合する.

主な方法:

MEDLINE (1966-2002) およびその他のリソースに関する包括的な文献検索.
疫学,病理学,動物モデル,細胞生物学,抗生物質治療試験の研究を含む.
診断,病理生理学,治療データの抽出と合意に基づく解釈.

主要な成果:

流行病学と病理学の研究は,C. pneumoniaeと動脈硬化症との関連性を確認しています.
実験室内および動物の研究では,C. pneumoniaeは,脂質および炎症経路に影響を及ぼし,アテロマの生物学に影響を与える可能性があることが示されています.
抗生物質の治験は混合的な結果を示している; 予備的な研究は冠動脈疾患の利点を示唆したが,より大きな治験は安定した冠動脈疾患の利点が見つかりませんでした.

結論:

クラミジア肺炎感染症は,動脈硬化症の必要なイニシアターである可能性は低い.
従来の抗生物質療法では,細菌を効果的に根絶したり,動脈硬化性血管疾患における死亡率を減らすことができない場合があります.
C. pneumoniaeは,心血管疾患における妥当かつ潜在的に修正可能な危険因子と考えられています.

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