Does atherosclerosis have an infectious etiology?
Does atherosclerosis have an infectious etiology?
复制标题
动脉粥样硬化有传染性病因吗？
作者：
L. Buja
动脉粥样硬化是血管壁对损伤的反应。1 仔细回顾流行病学研究表明，高胆固醇血症、吸烟和高血压等经典危险因素占动脉粥样硬化临床并发症（包括缺血性心脏病和急性心肌梗死）病因和发病机制的大部分，但不是全部。2 3 此外，对各种已确定的危险因素导致动脉粥样硬化的发生和进展的机制有确切的了解。病变不完整。这些事实促使研究人员寻找可能参与动脉粥样硬化及其并发症的病因和发病机制的其他可能的病因和因素。
最近受到广泛关注的另一种解释是动脉粥样硬化的感染理论。感染因子是动脉粥样硬化致病因子的假说最初是在本世纪前二十年提出的。 4 5 然而，直到 20 世纪 70 年代末，这一概念才受到很少关注，当时 Fabricant 等人 6 表明，实验性感染禽疱疹病毒的鸡出现了与人类动脉粥样硬化相似的华丽血管病变。随后，许多研究人员报告了某些感染因子与人类动脉粥样硬化疾病有关的观察结果。具体来说，已经提出了涉及肺炎衣原体、幽门螺杆菌、HSV 和 CMV 的观察结果……
Atherosclerosis develops as a response of the vessel wall to injury.1 Careful review of epidemiological studies indicates that the classic risk factors, eg, hypercholesterolemia, cigarette smoking, and hypertension, account for the majority but not the entirety of the etiology and pathogenesis of the clinical complications of atherosclerosis, including ischemic heart disease and acute myocardial infarction.2 3 Furthermore, exact knowledge regarding the mechanisms by which the various established risk factors contribute to the development and progression of lesions is incomplete. These facts have led investigators to pursue other possible etiologies and factors that may be involved in the etiology and pathogenesis of atherosclerosis and its complications.
An alternate explanation that recently has received considerable attention is the infectious theory of atherosclerosis. The hypothesis that infectious agents are causal agents in atherosclerosis originally was formulated in the first two decades of this century.4 5 However, this concept received little attention until the late 1970s, when Fabricant et al6 showed that chickens experimentally infected with an avian herpes virus developed florid vascular lesions similar to those of human atherosclerosis. Subsequently, many investigators have reported observations implicating certain infectious agents in human atherosclerotic disease. Specifically, observations have been presented implicating Chlamydia pneumoniae , Helicobacter pylori , HSV, and CMV …