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  Česky / Czech version Vnitř. Lék., 49, 2003, č. 12, No. 960 - 966
 
Infectious and Inflammatory Factors in Aetiology and Pathogenesis of Atherosclerosis 
Anděl M.1, Tsevegjav A.1, Roubalová K.2, Hrubá D.2, Dlouhý P.3, Kraml P.1 

12. interní klinika 3. lékařské fakulty UK a FN Královské Vinohrady, Praha, Centrum pro diabetes a výživu, přednosta prof. MUDr.Michal Anděl, CSc. 2Státní zdravotní ústav, Centrum epidemiologie a mikrobiologie, ředitel MUDr. Jaroslav Volf, Ph.D. 3Oddělení výživy CPL 3. lékařské fakulty UK, Praha, přednosta prof. MUDr. Michal Anděl, CSc.
 


Summary:

       Although the metabolic syndrome together with insulin resistance and their consequences are probably basic factors in pathogenesis of atherosclerosis, inflammatory and infectious aspects of this process are unquestionable only in some of the patients. Endothelial dysfunction was identified both in the experiment and in patients after herpes virus simplex 1 infection, cytomegaloviral infection, Chlamydia pneumoniae infection, or Helicobacter pylori infection. However, it is not clear whether it is always caused by direct specific activity of a given pathogen or whether it is a result of inflammatory cytokines activity, heat shock protein activity, or CRP activity. In recent years secondary antibiotic prevention in patients after myocardial infarction has been discussed. Lower mortality rate from acute myocardial infarction and cerebral vascular accidents were found in several observations of patients vaccinated against influenza. In patients with non-stable angina pectoris we have found significantly more frequent occurrence of IgG antibodies against Chalmydia pneumonie. This occurrence was more frequent in diabetics compared to non-diabetics. Endothelia exposed to cyto-megaloviral infection exprimed adhesive molecules on their surfaces. After an increase of the concentration of glucose in medium to 11.0 mmol/l and 16.5 mmol/l the expression of adhesive molecules after cyto-megaloviral infection increased. Relationship of infection, inflammation, and atherosclerosis has been a subject of intensive investigation in recent years. Discussion of possible consequences of these findings, especially from viewpoint of atherosclerosis prevention and its organ complications, is of the same intensity. Hypothesis about participation of infection and inflammation in pathogenesis of atherosclerosis seems to be very attractive. In spite of the fact that findings supporting this hypothesis cumulate final conclusion can’t be made yet.

        Key words: Atherosclerosis - Infection - Pathogenesis - Prevention - Treatment
       

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