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5 : The Association of Chlamydia pneumoniae and Atherogenesis

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Abstract:

This chapter attempts to frame the issues surrounding the association of atherosclerosis and infection with . The results of seroepidemiologic and histopathologic studies are discussed in addition to data from animal experiments. In vivo and in vitro experiments regarding the cell biology of and the immune response it engenders are explored. The chapter highlights features pertinent to a possible role in the pathogenesis of atherosclerosis. Finally, results from two recent antibiotic intervention studies are examined. A chlamydial infection was first associated with myocarditis as early as 1930, but the first series of patients with heart disease and a chlamydia infection was reported in 1967. The association between the and atherogenesis can build on a seroepidemiologic link. Murine and rabbit models have traditionally been used to study atherosclerosis and recently have been adapted for study of pathogenesis. There have been two recently published antibiotic intervention trials. The first published study is a prospective, double-blind, randomized trial in which patients with a remote history of myocardial infarction (MI) and elevated IgG titers to were randomized to one or two courses of azithromycin or to placebo. The second published study was a double-blind, randomized trial of roxithromycin compared to placebo in patients with evidence of coronary artery disease manifest as unstable angina or an active non-Q wave infarction. The association of and atherosclerosis is likely to evolve from additional pieces of supportive evidence.

Citation: Dunne M. 1998. The Association of Chlamydia pneumoniae and Atherogenesis, p 105-124. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch5

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Coronary Artery Disease
0.6985733
Infectious Diseases
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Outer Membrane Proteins
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Chlamydia trachomatis
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0.6985733
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Figure 1

Altered intracellular development of Chlamydia. (Reprinted with permission from reference .)

Citation: Dunne M. 1998. The Association of Chlamydia pneumoniae and Atherogenesis, p 105-124. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch5
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Image of Figure 2
Figure 2

Model of an activated macrophage in an atheromatous plaque. EB, element body; PB. persistent body; MHC. major histocompatibility complex.

Citation: Dunne M. 1998. The Association of Chlamydia pneumoniae and Atherogenesis, p 105-124. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch5
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Tables

Generic image for table
Table 1

Epidemiologic studies correlating risk of cardiovascular disease with exposure to

Citation: Dunne M. 1998. The Association of Chlamydia pneumoniae and Atherogenesis, p 105-124. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch5
Generic image for table
Table 2

Detection of in atherosclerotic plaques

Citation: Dunne M. 1998. The Association of Chlamydia pneumoniae and Atherogenesis, p 105-124. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch5
Generic image for table
Table 3

Impact of cortisone administration on recovery of from infected mice

Citation: Dunne M. 1998. The Association of Chlamydia pneumoniae and Atherogenesis, p 105-124. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch5
Generic image for table
Table 4

Effect of azithromycin on incidence of cardiovascular events

Citation: Dunne M. 1998. The Association of Chlamydia pneumoniae and Atherogenesis, p 105-124. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch5
Generic image for table
Table 5

Effect of roxithromycin on incidence of cardiovascular events

Citation: Dunne M. 1998. The Association of Chlamydia pneumoniae and Atherogenesis, p 105-124. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch5

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