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Inflammation, infection and antimicrobial therapy in coronary heart disease – where do we currently stand?
Author(s) -
Ngeh Joseph,
Gupta Sandeep
Publication year - 2001
Publication title -
fundamental and clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.655
H-Index - 73
eISSN - 1472-8206
pISSN - 0767-3981
DOI - 10.1046/j.1472-8206.2001.00021.x
Subject(s) - medicine , chlamydia , disease , etiology , chlamydophila pneumoniae , immunology , inflammation , diabetes mellitus , intensive care medicine , infectious disease (medical specialty) , antimicrobial , chlamydiales , biology , microbiology and biotechnology , endocrinology
Traditional atherosclerotic risk factors such as hypertension, smoking, hyperlipidaemia and diabetes mellitus, account for only about 50% of the clinical occurrence of coronary heart disease (CHD). The infectious hypothesis proposes that various microorganisms, in particular, Chlamydia pneumoniae , may serve as potential etiological factors, linking inflammation and atherosclerosis (or its clinical manifestations). Evidence from seroepidemiology, pathology, animal models, molecular biology and immunology, and human antibiotic intervention studies, collectively have suggested a largely positive association between C. pneumoniae infection and CHD. As CHD is a multifactorial disease, it is possible that C. pneumoniae may interact with conventional cardiovascular risk factors and predispose certain genetically susceptible people to atherosclerotic disease. However, the precise nature of a causal or coincidental link between C. pneumoniae and CHD remains to be determined. The results of ongoing antibiotic intervention studies may help to further clarify the role of infection and inflammation in CHD, but until such a role is proven beyond reasonable doubt, antimicrobial therapy cannot yet be justified in the treatment or prevention of CHD. A current perspective is presented in this review.