Is cardiovascular disease preventable by vaccination?

The possibility of using vaccination as a tool in the prevention of atheros clerotic disease was opened by the findings that infection with Chlamydia p neumoniae was an independent risk factor for cardiovascular disease, includ ing acute myocardial infarction. Since this finding, data have accumulated confirming the initial epidemiological association and demonstrating the pr esence of C. pneumoniae and/or its components in vascular lesions. Recent i ntervention trials with antimicrobial drugs have furthermore suggested a pa thogenetic relationship. The role of C. pneumoniae needs, however, to be fu rther confirmed before deciding on the use of a possible vaccine. At presen t, a vaccine for C. pneumoniae is not available but development is ongoing. The task is far from easy: the intracellular bacteria cannot be reached by antibodies, and the stimulation of CD8(+) T cells required for protection is difficult with a nonliving vaccine. On the other hand, recent advances i n biotechnology, including the sequence of the full genome of C. pneumoniae , provide unique tools for the work. With enough interest in the developmen t of a C. pneumoniae vaccine the first clinical trials could be expected in several years' time. They will, however, have to lye extensive in order to ascertain the safety of such a new type of vaccine intended far use in pop ulations in which many have already been infected with the bacteria and man y are chronic carriers. Who should be vaccinated is a question to be consid ered at that point.