Overview of infections and cardiovascular diseases

Microbes have been proposed as inciting agents of tissue injury and inflamm ation, both of which underlie the pathogenesis of atherosclerosis. Viruses, including the herpes simplex virus and cytomegalovirus, as well as bacteri a such as Chlamydia pneumoniae, have been Implicated in the process. In vit ro, these agents promote a proinflammatory and a procoagulant phenotype in vascular cells. Viruses augment cell accumulation through alterations of ap optosis. Infectious agents may play a role in pathogenesis of atheroscleros is by triggering an autoimmune response due to microbial molecular mimicry. It is unlikely that a single agent is the sole cause or modulator of this heterogeneous disease. Contradictory epidemiological studies may be reconci led with a new construct suggesting that multiple pathogens infecting an in dividual in aggregate may promote an inflammatory and procoagulant environm ent that underlies the pathogenesis of atherosclerosis.