CHLAMYDIA-PNEUMONIAE AND VASCULAR-DISEASE

Background There is an increasing body of evidence linking the human p athogen Chlamydia pneumoniae with atherosclerosis. Methods A Medline-b ased review of the literature was carried out. Results and conclusion Seroepidemiological studies have revealed the possibility that evidenc e of infection with C. pneumoniae and atherosclerotic disease are rela ted. Studies on human tissue have demonstrated that evidence of the or ganism can be found in human atherosclerotic tissue by both direct and indirect methods significantly more often than in control vascular ti ssue. Using animal models it is possible to show that C. pneumoniae ca n be disseminated haematogenously following pulmonary infection and th at it shows a tropism for atherosclerotic tissue. In vitro work has de monstrated that the organism is capable of infecting, surviving and mu ltiplying in cells of the human vascular wall, and that it can provoke a cell-mediated cytokine response which has implications both locally and systemically. Two clinical trials of macrolide antibiotics have d emonstrated that they confer increased cardiovascular protection in pa tients following myocardial infarction. Adequately powered trials are needed to establish the therapeutic role of antibiotics in peripheral arterial disease.