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. |
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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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