Infectious hypothesis of athersclerosis. An update
Keywords:
Cardiovascular disease, Atherosclerosis, Inflammation and InfectionAbstract
Background: Cardiovascular diseases (CVD) represent one of the major public health problems; ischemic heart disease is the leading cause of death in people over 45 years of age, followed by stroke (CVA). Atherosclerosis is the major pathogenic mechanism associated with both diseases and it involves lipid accumulation in the vascular endothelium, resulting from complex molecular and cellular responses that may be described as progressive and chronic inflammatory disease associated with infection. Objective: To update the knowledge on molecular aspects and involvement of infections and inflammatory re- sponse in the pathogenesis of atherosclerotic plaque. Methods: The literature available in English and Spanish published between 1978 and 2012 was reviewed. Using key terms cardiovascular diseases, atherosclerosis, inflammation and infection and their equivalents in Spanish, Medline was accessed, division Highwire Library of Stanford University and the Virtual Health Library, further physical information was acquired in local libraries. The unit of analysis was the association between infection and atherosclerotic disease. Results: The available literature contains numerous scientific evidences to support from a molecular level, the involvement of infections in the development of atherosclerotic diseases through inflammatory mechanisms of endothelial injury. Conclusion: Infections arise as emerging risk factors for cardiovascular disease and it is necessary to increase the level of knowledge about specifi c infec
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References
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6.Kaski JC. Inflamación, infección y enferme- dad coronaria: mitos y realidades. Conferen- cia Especial del XXXV Congreso Nacional de la Sociedad Española de Cardiología. RevEs- pCardiol [en línea] 2000 [fecha de acceso 30 de enero de 2005]; 53:1311-1317. URL. Dis- ponible en: http://www.revespcardiol.org/ cgibin/wdbcgi.exe/cardio/mrevista_cardio. fulltext?pident=11944
7.Ridker P, Libby P. Risk factors for atherothrom- botic disease. In Zipes D, editor: Braunwalds heart disease: 7th ed. Philadelphia: Elsevier Saunders; 2005.
8.Gurfinkel EP. Nuevos factores de riesgo car- diovascular. Cardiología basada en la eviden- cia y experiencia de la Fundación Favaloro. Buenos Aires: Editorial Guía; 2003.
9.Skarlatos S, Libby P, Egan D. Roles of infec- tious agents in atherosclerosis and reste- nosis: an assessment of the evidence and need for future research. Circulation. 1997; 96:4095-4103.
10.Sess R, Nicoletti M, Di Pietro M, Schiavoni G, Santino I, Zagaglia C, et al. Chlamydia pneu- moniae and atherosclerosis: current state and future prospectives. Int J Immunopathol Pharmacol. 2009; 22(1): 9-14.
11.Linares Palomino JP, Gutiérrez Fernández C, López Estrada M, Rodríguez Fernández C, Maroto Vela E. Infección en Angiología y Cirugía Vascular. Barcelona: URIACH; 1999.
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13.Laguens RP, González PH. Patología de la at- erosclerosis. En: Mautner B ed. Cardiología basada en la evidencia y experiencia de la Fundación Favaloro. Buenos Aires: Editorial Guía; 2003.
14.Stary HC, Chandler AB, Glagov S, Guyton JR, Insull W Jr, Rosenfeld ME, et al. A definition of initial, fatty streak, and intermediate le- sions of atherosclerosis: a report from the Committee on Vascular Lesions of the Coun- cil on Arteriosclerosis, American Heart Asso- ciation. Circulation. 1994; 89:2462-2478.
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16.Rodríguez J, Orbe J, Páramo J. Metalopro- teasas, remodelado vascular y síndromes aterotrombóticos. Rev Esp Cardiol. 2007; 60(9):959-67.
17.Russell, R. Atherosclerosis-An Inflammatory Disease. N Eng J Med; 1999; 340:115-126.
18.Ross R. Atherosclerosis - A problem of the biology of arterial wall cells and their inter- actions with blood components. Arterioscle- rosis. 1981; 1:293-311.
19.Rodríguez G, Mago N y Rosa F. El papel de la inflamación en la aterogénesis. Invest Clin. 2009; 50(1):109-129.
20.Borrero J, Céspedes M, Peña M, Suárez N, Olivero R. Mecanismos moleculares impli- cados en las enfermedades cardiovasculares aterotrombóticas. [Artículo en internet]. La Habana, Cuba: Facultad de Ciencias Médicas “General Calixto García”; [Citado 2012 abril 28]. Disponible en: http://bvs.sld.cu/revis- tas/mgi/vol28_3_12/mgi08312.htm
21.Libby P, Ridker P, Maseri A. Inflammation and atherosclerosis. Circulation. 2002; 105:1135- 1143.
22.Tedgui A, Mallat Z. Cytokines in atheroscle- rosis: Pathogenic and regulatory pathways. Physiol Rev. 2006; 86:515-581.
23.Stemme S, Faber B, Holm J, Wiklund O, Witztum J, Hansson G. T lymphocytes from human atherosclerotic plaques recognize oxidized low density lipoprotein. Proc Natl. Acad Sci USA. 1995; 92:3893-97.
24.Ayada K, Yokota K, Kobayashi K, Shoenfeld Y, Matsuura E, Oguma K. Chronic infections and atherosclerosis. Ann N Y Acad Sci. 2007; 1108:594-602.
25.Shi Y, Tokunaga O. Chlamydia pneumoniae and multiple infections in the aorta contrib- ute to atherosclerosis. Pathol Int. 2002 Dec; 52(12):755-63.
26.Gawaz M, Langer H, May A. Platelets in in- flammation and atherogenesis. J Clin Invest. 2006; 115:3378-84.
27.Larsen MM, Moern B, Fuller A, Andersen PL, Ostergaard LJ. Chlamydia pneumoniae and cardiovascular disease. MJA [serial on- line] 2002 [fecha de acceso 19 de enero de 2006] 177;177:558-562. URL. Disponible en:http://www.mja.com.au/public/is- sues/177_10_181102/lar10257_fm
28.Fabricant CG, Fabricant J, Litrenta MM, Minick CR. Virus-induced atherosclerosis. J Exp Med. 1978; 148:335-340.
29.Fabricant CG, Hajjar DP, Minnick CR, Fabri- cant J. Herpesvirus infection enhances cho- lesterol and cholesteryl ester accumulation in cultured arterial smooth muscle cells. Am J Path. 1981; 105:176-184.
30.Epstein SE, Speir E, Zhou YF, Guetta E, Leon M, Finkel T. The role of infection in restenosis and atherosclerosis: focus on cytomegalovi- rus. Lancet. 1996; 348:S13-S16.
31. Sung JJ, Sanderson JE. Hyperhomocysteinae- mia, Helicobacter pylori, and coronary heart disease. Heart. 1996; 76:305-307.
32.Stassen FR, Vainas T, Bruggeman CA. Infec- tion and atherosclerosis: analternative view on an out dated hypothesis. Pharmacol Rep. 2008; 60(1):85-92.
33.Muhlestein J B. Infección crónica y arteriopa- tia coronaria. Medical Clinics of North Amer- ica (ed español). 2000; 84:127-152.
34.Gurfinkel EP. Infección y aterosclerosis. Rev Esp Cardiol [en línea] 2001 [fecha de acceso 10 de febrero de 2006]; 54:383-392. URL. Disponible en: http://www.revespcardiol. org/cgibin/wdbcgi.exe/cardio/mrevista_car- dio.fulltext?pident=10021525
35.Campbell LA, Kuo CC. Chlamydia pneumoni- ae--an infectious risk factor for atherosclero- sis? Nat Rev Microbiol. 2004; 2(1):23-32.
36.Villegas E, Sorlózano A, Gutiérrez J. Serologi- cal diagnosis of Chlamydia pneumoniae in- fection: limitations and perspectives. J Med Microbiol. 2010; 59:1267-74.
37.Kalayoglu MV, Hoerneman B, LaVerda D, Morrison SG, Morrison RP, Byrne GI. Cellular oxidation of low density lipoprotein by Chla- mydia pneumoniae. J InfectDis. 1999; 180: 780-90.
38.Bauriedel G, Hutter R, Lüderitz B. Azithro- mycin, Chlamydia pneumoniae, and intimal thickening. Circulation. 1998; 98:2357.
39.Grayston JT, Kuo CC, Wang SP, Aitman JA. New Chlamydia psittaci strain calied TWAR from acute respiratory tract infections. J Med. 1986; 315:161-8.
40.Saikku P, Leinonen M, Tenkanen L, Linnanmá- ki E. Chronic Chlamydia pneumoniae infec- tion as risk factor for coronary heart disease in the Helsinki Heart Study. Ann Intern Med. 1992; 116:273-8.
41.Ridker P, Kundsin R, Stampfer M. Prospective study of Chlamydia pneumoniae IgG sero- positivity and risks of future myocardial in- farction. Circulation. 1999; 99:1161-65.
42.Shor A, Kuo CC, Patton DL. Detection of Chla- mydia pneumoniae in coronary arterial fatty streaks and atheromatous plaques. S Afr Med J. 1992; 82:15861.
43.Muhlestein JB, Hammond EH, Carlquist JF, Radicke E, Thomson MJ, Karagounis LA, et al. Increased incidence of Chlamydia species within the coronary arteries of patients with symptomatic atherosclerotic versus other forms of cardiovascular disease. J Am Coll Cardiol. 1996; 27:1555-61.
44.Garcia A, Bustamante J, Zapata J, Atehortua S, Bañol J, Barrera M, Guete JC, Marin A. De- tección de Chlamydia pneumoniae en válvu- las aórticas y mitrales humanas. RevFedArg- Cardiol. 2003; 32:209-219.
45.Boman J, Hammerschlag MR. Chlamydia pneumoniae and atherosclerosis: critical assessment of diagnostic methods and rel- evance to treatment studies. Clin Microbiol Rev. 2002; 15:1-20.
46.Korner I, Blatz R, Wittig I, Pfeiffer D, Ruhl- mann C. Serological evidence of Chlamydia pneumoniae lipopolysaccharide antibodies in aterosclerosis of various vascular regions. Vasa. 1999; 28:25963.
47.Fong IW, Chiu B, Viira E, Jang D, Mahony JB. De novo induction of atherosclerosis by Chla- mydia pneumoniae in a rabbit model. Infec- tion and Immunity. 1999; 67:6048-55.
48.Watson C, Alp NJ. Role of Chlamydia pneu- moniae in atherosclerosis. Clinical Science. 2008; 114:509-31.
49.Fong IW, Chiu B, Viira E, Jang D, Fong M, Peel- ing R, et al. Can an antibiotic (Macrolide) pre- vent Chlamydia pneumoniae-induced ath- erosclerosis in a rabbit model?. Clinical and Diagnostic Laboratory Immunology. 1999; 6:891-94.
50.Prevención de las enfermedades cardiovas- culares. Guía de bolsillo para la estimación y el manejo del riesgo cardiovascular. Ginebra: Organización Mundial de la Salud; 2008.
2.Roger VL. Epidemiology of Myocardial Infarc- tion. MedClin N Am. 2007; 91:537-552.
3.Rosamond W, Flegal K, Furie K, Go A, Green- lund K, Haase N, et al. Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommit- tee. Circulation. 2008; 117(4):25-146.
4.Así vamos en Salud.org; [página web en In- ternet]. Bogotá: Tendencias en salud en Colombia 2009 [actualizado 05 sep 2011; citado 9 mayo 2012]. Disponible en: http:// www.asivamosensalud.org/media/santafe/ publicacion/027e8963b9e6cf9d65df7c7f53b 8c380.pdf
5.Gobernación del Atlántico. Plan de Desar- rollo Departamental 2012-2015 “Atlántico más Social. Compromiso Social sobre lo Fun- damental”. [libro en Internet] [Citado junio 2 de 2012]. Disponible en: http://educon. javeriana.edu.co/ofi/documentos/regional- izacion/Planes%20desarrollo/Departamen- tos/ATLANTICO%202012_2015.pdf
6.Kaski JC. Inflamación, infección y enferme- dad coronaria: mitos y realidades. Conferen- cia Especial del XXXV Congreso Nacional de la Sociedad Española de Cardiología. RevEs- pCardiol [en línea] 2000 [fecha de acceso 30 de enero de 2005]; 53:1311-1317. URL. Dis- ponible en: http://www.revespcardiol.org/ cgibin/wdbcgi.exe/cardio/mrevista_cardio. fulltext?pident=11944
7.Ridker P, Libby P. Risk factors for atherothrom- botic disease. In Zipes D, editor: Braunwalds heart disease: 7th ed. Philadelphia: Elsevier Saunders; 2005.
8.Gurfinkel EP. Nuevos factores de riesgo car- diovascular. Cardiología basada en la eviden- cia y experiencia de la Fundación Favaloro. Buenos Aires: Editorial Guía; 2003.
9.Skarlatos S, Libby P, Egan D. Roles of infec- tious agents in atherosclerosis and reste- nosis: an assessment of the evidence and need for future research. Circulation. 1997; 96:4095-4103.
10.Sess R, Nicoletti M, Di Pietro M, Schiavoni G, Santino I, Zagaglia C, et al. Chlamydia pneu- moniae and atherosclerosis: current state and future prospectives. Int J Immunopathol Pharmacol. 2009; 22(1): 9-14.
11.Linares Palomino JP, Gutiérrez Fernández C, López Estrada M, Rodríguez Fernández C, Maroto Vela E. Infección en Angiología y Cirugía Vascular. Barcelona: URIACH; 1999.
12.Expert Panel on Detection, Evaluation and Treatment on High Blood Cholesterol in Adults: Executive summary of the third re- port of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment on High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001; 285:2486-97.
13.Laguens RP, González PH. Patología de la at- erosclerosis. En: Mautner B ed. Cardiología basada en la evidencia y experiencia de la Fundación Favaloro. Buenos Aires: Editorial Guía; 2003.
14.Stary HC, Chandler AB, Glagov S, Guyton JR, Insull W Jr, Rosenfeld ME, et al. A definition of initial, fatty streak, and intermediate le- sions of atherosclerosis: a report from the Committee on Vascular Lesions of the Coun- cil on Arteriosclerosis, American Heart Asso- ciation. Circulation. 1994; 89:2462-2478.
15.Bermejo GJ, Martínez MP, Rodríguez JF, De la Torre M, Bustamante R, Guerrero A, et al. Inflamación e infección en la enfermedad coronaria estable y en el síndrome coronario agudo. RevEspCardiol [en línea] 2001 [fecha de acceso 3 de febrero de 2006]; 54:453- 459.URL.Disponible en: http://www.revesp- cardiol.org/cgibin/wdbcgi.exe/cardio/mre- vista_cardio.fulltext?pident=11000056
16.Rodríguez J, Orbe J, Páramo J. Metalopro- teasas, remodelado vascular y síndromes aterotrombóticos. Rev Esp Cardiol. 2007; 60(9):959-67.
17.Russell, R. Atherosclerosis-An Inflammatory Disease. N Eng J Med; 1999; 340:115-126.
18.Ross R. Atherosclerosis - A problem of the biology of arterial wall cells and their inter- actions with blood components. Arterioscle- rosis. 1981; 1:293-311.
19.Rodríguez G, Mago N y Rosa F. El papel de la inflamación en la aterogénesis. Invest Clin. 2009; 50(1):109-129.
20.Borrero J, Céspedes M, Peña M, Suárez N, Olivero R. Mecanismos moleculares impli- cados en las enfermedades cardiovasculares aterotrombóticas. [Artículo en internet]. La Habana, Cuba: Facultad de Ciencias Médicas “General Calixto García”; [Citado 2012 abril 28]. Disponible en: http://bvs.sld.cu/revis- tas/mgi/vol28_3_12/mgi08312.htm
21.Libby P, Ridker P, Maseri A. Inflammation and atherosclerosis. Circulation. 2002; 105:1135- 1143.
22.Tedgui A, Mallat Z. Cytokines in atheroscle- rosis: Pathogenic and regulatory pathways. Physiol Rev. 2006; 86:515-581.
23.Stemme S, Faber B, Holm J, Wiklund O, Witztum J, Hansson G. T lymphocytes from human atherosclerotic plaques recognize oxidized low density lipoprotein. Proc Natl. Acad Sci USA. 1995; 92:3893-97.
24.Ayada K, Yokota K, Kobayashi K, Shoenfeld Y, Matsuura E, Oguma K. Chronic infections and atherosclerosis. Ann N Y Acad Sci. 2007; 1108:594-602.
25.Shi Y, Tokunaga O. Chlamydia pneumoniae and multiple infections in the aorta contrib- ute to atherosclerosis. Pathol Int. 2002 Dec; 52(12):755-63.
26.Gawaz M, Langer H, May A. Platelets in in- flammation and atherogenesis. J Clin Invest. 2006; 115:3378-84.
27.Larsen MM, Moern B, Fuller A, Andersen PL, Ostergaard LJ. Chlamydia pneumoniae and cardiovascular disease. MJA [serial on- line] 2002 [fecha de acceso 19 de enero de 2006] 177;177:558-562. URL. Disponible en:http://www.mja.com.au/public/is- sues/177_10_181102/lar10257_fm
28.Fabricant CG, Fabricant J, Litrenta MM, Minick CR. Virus-induced atherosclerosis. J Exp Med. 1978; 148:335-340.
29.Fabricant CG, Hajjar DP, Minnick CR, Fabri- cant J. Herpesvirus infection enhances cho- lesterol and cholesteryl ester accumulation in cultured arterial smooth muscle cells. Am J Path. 1981; 105:176-184.
30.Epstein SE, Speir E, Zhou YF, Guetta E, Leon M, Finkel T. The role of infection in restenosis and atherosclerosis: focus on cytomegalovi- rus. Lancet. 1996; 348:S13-S16.
31. Sung JJ, Sanderson JE. Hyperhomocysteinae- mia, Helicobacter pylori, and coronary heart disease. Heart. 1996; 76:305-307.
32.Stassen FR, Vainas T, Bruggeman CA. Infec- tion and atherosclerosis: analternative view on an out dated hypothesis. Pharmacol Rep. 2008; 60(1):85-92.
33.Muhlestein J B. Infección crónica y arteriopa- tia coronaria. Medical Clinics of North Amer- ica (ed español). 2000; 84:127-152.
34.Gurfinkel EP. Infección y aterosclerosis. Rev Esp Cardiol [en línea] 2001 [fecha de acceso 10 de febrero de 2006]; 54:383-392. URL. Disponible en: http://www.revespcardiol. org/cgibin/wdbcgi.exe/cardio/mrevista_car- dio.fulltext?pident=10021525
35.Campbell LA, Kuo CC. Chlamydia pneumoni- ae--an infectious risk factor for atherosclero- sis? Nat Rev Microbiol. 2004; 2(1):23-32.
36.Villegas E, Sorlózano A, Gutiérrez J. Serologi- cal diagnosis of Chlamydia pneumoniae in- fection: limitations and perspectives. J Med Microbiol. 2010; 59:1267-74.
37.Kalayoglu MV, Hoerneman B, LaVerda D, Morrison SG, Morrison RP, Byrne GI. Cellular oxidation of low density lipoprotein by Chla- mydia pneumoniae. J InfectDis. 1999; 180: 780-90.
38.Bauriedel G, Hutter R, Lüderitz B. Azithro- mycin, Chlamydia pneumoniae, and intimal thickening. Circulation. 1998; 98:2357.
39.Grayston JT, Kuo CC, Wang SP, Aitman JA. New Chlamydia psittaci strain calied TWAR from acute respiratory tract infections. J Med. 1986; 315:161-8.
40.Saikku P, Leinonen M, Tenkanen L, Linnanmá- ki E. Chronic Chlamydia pneumoniae infec- tion as risk factor for coronary heart disease in the Helsinki Heart Study. Ann Intern Med. 1992; 116:273-8.
41.Ridker P, Kundsin R, Stampfer M. Prospective study of Chlamydia pneumoniae IgG sero- positivity and risks of future myocardial in- farction. Circulation. 1999; 99:1161-65.
42.Shor A, Kuo CC, Patton DL. Detection of Chla- mydia pneumoniae in coronary arterial fatty streaks and atheromatous plaques. S Afr Med J. 1992; 82:15861.
43.Muhlestein JB, Hammond EH, Carlquist JF, Radicke E, Thomson MJ, Karagounis LA, et al. Increased incidence of Chlamydia species within the coronary arteries of patients with symptomatic atherosclerotic versus other forms of cardiovascular disease. J Am Coll Cardiol. 1996; 27:1555-61.
44.Garcia A, Bustamante J, Zapata J, Atehortua S, Bañol J, Barrera M, Guete JC, Marin A. De- tección de Chlamydia pneumoniae en válvu- las aórticas y mitrales humanas. RevFedArg- Cardiol. 2003; 32:209-219.
45.Boman J, Hammerschlag MR. Chlamydia pneumoniae and atherosclerosis: critical assessment of diagnostic methods and rel- evance to treatment studies. Clin Microbiol Rev. 2002; 15:1-20.
46.Korner I, Blatz R, Wittig I, Pfeiffer D, Ruhl- mann C. Serological evidence of Chlamydia pneumoniae lipopolysaccharide antibodies in aterosclerosis of various vascular regions. Vasa. 1999; 28:25963.
47.Fong IW, Chiu B, Viira E, Jang D, Mahony JB. De novo induction of atherosclerosis by Chla- mydia pneumoniae in a rabbit model. Infec- tion and Immunity. 1999; 67:6048-55.
48.Watson C, Alp NJ. Role of Chlamydia pneu- moniae in atherosclerosis. Clinical Science. 2008; 114:509-31.
49.Fong IW, Chiu B, Viira E, Jang D, Fong M, Peel- ing R, et al. Can an antibiotic (Macrolide) pre- vent Chlamydia pneumoniae-induced ath- erosclerosis in a rabbit model?. Clinical and Diagnostic Laboratory Immunology. 1999; 6:891-94.
50.Prevención de las enfermedades cardiovas- culares. Guía de bolsillo para la estimación y el manejo del riesgo cardiovascular. Ginebra: Organización Mundial de la Salud; 2008.
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