Altun Belgin, Rota Seyyal, Demircin Metin, Reşatoğlu Adem, Yener Ali, Bozdayi Gülendam
Hacettepe Universitesi Tip Fakültesi, Iç hastaliklan Anabilim Dali, Enfeksiyon Hastaliklan Unitesi, Ankara.
Mikrobiyol Bul. 2007 Oct;41(4):537-44.
It is assumed that various infectious agents play direct or indirect roles in the pathogenesis of atherosclerosis which is accepted as a chronic inflammatory phenomenon. However, the data obtained from different studies are contradictory. The aim of this study was to investigate the roles of herpes virus group [Herpes simplex virus (HSV), Epstein-Barr virus (EBV), Cytomegalovirus (CMV)] and hepatitis A virus (HAV) which are debated in terms of their impact in the pathogenesis of coronary arterial diseases. For this purpose, atherome plaque samples collected from 28 patients (23 were male; age range: 43-74 years) with atherosclerotic heart disease and vein samples from 22 control patients (19 were male; age range: 37-85 years) who had vascular diseases other than atherosclerosis, were investigated by means of the presence of nucleic acids of the above mentioned viruses by real-time polymerase chain reaction (PCR). Besides, classical cardiovascular risk factors (hypertension, hyperlipidemia, hypercholestrolemia, diabetes mellitus, smoking habits, gender, age and familial background) were questioned in both patient and control groups. As a result, no positivity were detected for nucleic acids of HSV type 1 and 2, EBV and HAV, whereas CMV-DNA was found positive in three of 28 (10.7%) atheromateous plaques (viral loads were 21, 188 and 288 copies/mg). Amongst 22 vascular samples from controls, two (9.1%) yielded positive results for EBV-DNA (viral loads were 5 and 10 copies/mg), while the other samples were found negative for nucleic acids of HSV type 1 and 2, CMV and HAV. The evaluation of the known risk factors for atherosclerosis revealed that, the difference between the presence of hypertension and hyperlipidemia which are the major risk factors, was statistically important (p < 0.05) in patient group (64% and 50%, respectively) and control group (32% and 23%, respectively). In conclusion, the hypothesis concerning the possible relationship between these viral agents and the progression of atherosclerosis, have not been supported by our data which are similar to the results obtained from various other studies. Actually, further studies are needed to clarify such direct or indirect roles of infectious agents in the pathogenesis of coronary arterial diseases.
人们认为,各种感染因子在动脉粥样硬化的发病机制中直接或间接发挥作用,动脉粥样硬化被认为是一种慢性炎症现象。然而,不同研究获得的数据相互矛盾。本研究的目的是调查疱疹病毒组[单纯疱疹病毒(HSV)、爱泼斯坦-巴尔病毒(EBV)、巨细胞病毒(CMV)]和甲型肝炎病毒(HAV)在冠状动脉疾病发病机制中的作用,这些病毒在这方面存在争议。为此,通过实时聚合酶链反应(PCR)检测上述病毒核酸的存在情况,对28例患有动脉粥样硬化性心脏病的患者(23例男性;年龄范围:43 - 74岁)的动脉粥样硬化斑块样本和22例患有除动脉粥样硬化以外的血管疾病的对照患者(19例男性;年龄范围:37 - 85岁)的静脉样本进行了研究。此外,对患者组和对照组都询问了经典的心血管危险因素(高血压、高脂血症、高胆固醇血症、糖尿病、吸烟习惯、性别、年龄和家族背景)。结果,未检测到1型和2型HSV、EBV和HAV的核酸呈阳性,而在28个动脉粥样硬化斑块中有3个(10.7%)检测到CMV - DNA呈阳性(病毒载量分别为21、188和288拷贝/毫克)。在22个来自对照组的血管样本中,有2个(9.1%)EBV - DNA检测呈阳性(病毒载量分别为5和10拷贝/毫克),而其他样本中1型和2型HSV、CMV和HAV的核酸检测均为阴性。对已知的动脉粥样硬化危险因素的评估显示,主要危险因素高血压和高脂血症的存在情况在患者组(分别为64%和50%)和对照组(分别为32%和23%)之间的差异具有统计学意义(p < )。总之,关于这些病毒因子与动脉粥样硬化进展之间可能存在关系的假设,未得到我们的数据支持,我们的数据与其他各种研究的结果相似。实际上,需要进一步研究来阐明感染因子在冠状动脉疾病发病机制中的这种直接或间接作用。