Chronic Infection, Chlamydia and Coronary Heart Disease

Front Cover
Springer Science & Business Media, Nov 23, 2007 - Medical - 146 pages
Coronary heart disease (CHD) remains a major cause of human mortality and morbidity worldwide. Classical risk factors for atherosclerosis fail to account fully for the wide variations in CHD prevalence and/or severity between differing populations. The search for hitherto unrecognised risk factors has recently focused on the potential role of chronic inflammation and common infections.
Chronic Infection, Chlamydia and Coronary Heart Disease is the first book to review the wealth of evidence linking various infective agents with CHD, focusing particularly on the proposed pathogenetic role of the main candidate microorganism, Chlamydia pneumoniae.
Written by two leading investigators in the field, the book provides a concise, clearly written and up-to-date account of the diverse lines of evidence - seroepidemiological, pathological, animal and in vitro data and clinical antibiotic trials.
The possibility of an infective basis to atherosclerosis and CHD has already attracted much scientific interest. Chronic Infection, Chlamydia and Coronary Heart Disease highlights the key published works on the topic, and concludes with information on existing, ongoing, and future lines of enquiry.
 

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Contents

Atherosclerosis and coronary heart disease
1
So why the variations?
2
What is atherosclerosis?
3
Classical hypotheses of atherogenesis
5
The endothelium and its response to injury
6
Acute inflammation and plaque activity
9
Cells mediators and CHD risk
10
Summary
17
References
61
Association of Chlamydia pneumoniae with atherosclerosis The evidence
64
Direct examination of atheromatous plaques
72
Culture of C pneumoniae from atheroma
80
Evidence from peripheral blood PCR studies
81
Animal models
82
What about Kochs postulates?
86
References
88

References
18
Associations between infective microorganisms and atherosclerosis
23
How might infections be involved?
24
Which infections?
25
Helicobacter pylori
33
Dental infections
36
Other infections associated with CHD
38
What about C pneumoniae?
41
References
43
Chlamydia pneumoniae Natural history epidemiology and microbiology
48
Epidemiology of C pneumoniae
52
Chronic C pneumoniae infection
53
Diagnosis of C pneumoniae infection
54
Antibiotic treatment of C pneumoniae infection
59
Summary
60
Association of Chlamydia pneumoniae with atherosclerosis Potential pathogenetic mechanisms
92
Persistent pharyngeal carriage of C pneumoniae in patients with CHD
93
Possible interaction of C pneumoniae and classical CHD risk factors
96
Summary
99
References
101
Clinical antibiotic trials in coronary heart disease
104
Pilot antibiotic studies
107
Ongoing prospective antibiotic studies
114
Potential limitations of the antibiotic studies
117
How the antibiotic studies should help
118
References
120
A perspective on Chlamydia pneumoniae and coronary heart disease
121
References
127
Index
128
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