Mussa Firas F, Chai Hong, Wang Xinwen, Yao Qizhi, Lumsden Alan B, Chen Changyi
Molecular Surgeon Research Center, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
J Vasc Surg. 2006 Jun;43(6):1301-7. doi: 10.1016/j.jvs.2006.02.050.
Exposure to Chlamydia pneumoniae is extremely common, and its incidence increases with age. C pneumoniae infection is strongly associated with coronary artery disease, as well as with atherosclerosis of the carotid artery, aorta, and peripheral arteries. This association has been shown in seroepidemiologic studies and by direct detection of the organism in atherosclerotic lesions by immunohistochemistry, polymerase chain reaction, electron microscopy, and tissue culture. Animal models of atherosclerosis have been used to study the role of C pneumoniae in the initiation and progression of atherosclerotic disease. The association of this organism with cardiovascular complications has inspired many human trials of antibiotics for the secondary prevention of atherosclerosis. C pneumoniae can infect several types of cells, including circulating macrophages, arterial smooth muscle cells, and vascular endothelial cells, causing the secretion of proinflammatory cytokines and procoagulants by endothelial cells and foam cell formation by infected macrophages. This report reviews the role of C pneumoniae in atherogenesis in light of recent, large antibiotic treatment trials, animal studies, and in vitro studies. The role of Chlamydia heat shock protein as a potential mediator of this harmful effect is also reviewed.
接触肺炎衣原体极为常见，其发病率随年龄增长而增加。肺炎衣原体感染与冠状动脉疾病以及颈动脉、主动脉和外周动脉的动脉粥样硬化密切相关。这种关联已在血清流行病学研究中得到证实，并且通过免疫组织化学、聚合酶链反应、电子显微镜和组织培养在动脉粥样硬化病变中直接检测到该病原体得以体现。动脉粥样硬化动物模型已被用于研究肺炎衣原体在动脉粥样硬化疾病发生和发展中的作用。这种病原体与心血管并发症的关联引发了许多关于抗生素用于动脉粥样硬化二级预防的人体试验。肺炎衣原体可感染多种类型的细胞，包括循环巨噬细胞、动脉平滑肌细胞和血管内皮细胞，导致内皮细胞分泌促炎细胞因子和促凝剂，并使受感染的巨噬细胞形成泡沫细胞。本报告根据近期大型抗生素治疗试验、动物研究和体外研究，综述了肺炎衣原体在动脉粥样硬化形成中的作用。还综述了衣原体热休克蛋白作为这种有害作用潜在介质的作用。
