title: Infectious burden and atherosclerosis: A clinical issue.
abstract: Atherosclerotic cardiovascular diseases, chronic inflammatory diseases of multifactorial etiology, are the leading cause of death worldwide. In the last decade, more infectious agents, labeled as "infectious burden", rather than any single pathogen, have been showed to contribute to the development of atherosclerosis through different mechanisms. Some microorganisms, such as Chlamydia pneumoniae (C. pneumoniae), human cytomegalovirus, etc. may act directly on the arterial wall contributing to endothelial dysfunction, foam cell formation, smooth muscle cell proliferation, platelet aggregation as well as cytokine, reactive oxygen specie, growth factor, and cellular adhesion molecule production. Others, such as Helicobacter pylori (H. pylori), influenza virus, etc. may induce a systemic inflammation which in turn may damage the vascular wall (e.g., by cytokines and proteases). Moreover, another indirect mechanism by which some infectious agents (such as H. pylori, C. pneumoniae, periodontal pathogens, etc.) may play a role in the pathogenesis of atherosclerosis is molecular mimicry. Given the complexity of the mechanisms by which each microorganism may contribute to atherosclerosis, defining the interplay of more infectious agents is far more difficult because the pro-atherogenic effect of each pathogen might be amplified. Clearly, continued research and a greater awareness will be helpful to improve our knowledge on the complex interaction between the infectious burden and atherosclerosis.
authors.affiliation: Rosa Sessa, Marisa Di Pietro, Simone Filardo, Department of Public Health and Infectious Diseases, "Sapienza" University, 00185 Rome, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Sessa
authors.affiliation: Rosa Sessa, Marisa Di Pietro, Simone Filardo, Department of Public Health and Infectious Diseases, "Sapienza" University, 00185 Rome, Italy.
authors.forename: Marisa Di
authors.initials: MD
authors.lastname: Pietro
authors.affiliation: Rosa Sessa, Marisa Di Pietro, Simone Filardo, Department of Public Health and Infectious Diseases, "Sapienza" University, 00185 Rome, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Filardo
authors.affiliation: Rosa Sessa, Marisa Di Pietro, Simone Filardo, Department of Public Health and Infectious Diseases, "Sapienza" University, 00185 Rome, Italy.
authors.forename: Ombretta
authors.initials: O
authors.lastname: Turriziani
keywords: Atherosclerosis; Bacteria; Infectious burden; Pathogenetic mechanisms; Virus