[Infective Chlamydia pneumoniae and coronary disease: where is the truth?].

Chlamydia pneumoniae has been associated with atherosclerosis and coronary heart disease for several years. This association is based upon 4 research areas: 1. seroepidemiological studies, 2. detection of the pathogen in diseased arteries, 3. experimental studies in vitro and in animal models, and 4. human intervention trials with antibiotics. We review and discuss recent data from these four areas. Although the infectious hypothesis of atherosclerosis is not new, the bulk of evidence supporting a role for C. pneumoniae is important. However, a definite pathogenic role for initiating or accelerating the athreosclerotic process remains unproven. Several large clinical trials with antibiotic interventions in patients with coronary heart disease are ongoing. Treatment of C. pneumoniae infection and the perspectives for a vaccine remain, however, problematic.