The Role of Infection in Carotid Plaque Pathogenesis and Stability: The Clinical Evidence

Makris, Gregory C.; Makris, Marinos C.; Wilmot, Victoria; Geroulakos, George; Falagas, Matthew E.

doi:10.2174/157016110793563889

Cited by 15 publications

(11 citation statements)

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“…In the present study, the connection of procalcitonin level with the presence of unstable ICA stenoses was not confirmed, either. Determination of procalcitonin levels is a test used in clinical practice for diagnosing bacterial infections with a systemic response, which are included among the probable factors participating in the pathogenesis of atherosclerosis [6, 38]. However, the role of infections of atherosclerotic plaques in their destabilisation has not been unequivocally confirmed [39, 40].…”

Section: Discussionmentioning

confidence: 99%

Inflammatory markers in patients with internal carotid artery stenosis

Puz¹,

Lasek–Bal²,

Ziaja³

et al. 2013

aoms

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IntroductionAvailable reports underline the significance of the inflammatory process in the development, progression and destabilisation of atherosclerotic plaques in the internal carotid artery (ICA). The aim of this study was to evaluate the relationship between the degree of ICA stenosis, ultrasound plaque morphology and serum concentration of selected inflammatory markers.Material and methodsSixty-five patients with ICA stenosis > 50% (39 symptomatic) and 30 healthy volunteers were enrolled in the study. Clinical, neurological examination and laboratory evaluation (leucocyte count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen, tumour necrosis factor-α (TNF-α), interleukins (1β, 6 and 10), anti-cytomegalovirus IgG antibody titre) were performed. Stenosis grade ≥ 70%, ulcerations on the plaque surface and a hypoechoic (or predominantly hypoechoic) structure of the plaque, obtained by colour-coded duplex examination, were accepted as the characteristics of unstable stenoses.ResultsUnstable ultrasound features of ICA stenosis were found significantly more often in symptomatic than in asymptomatic patients (71.79% vs. 30.71% for stenosis degree ≥ 70%, p = 0.001 and 61.23% vs. 38.46% for unstable plaque morphology, p = 0.01). Patients with ICA stenosis had significantly higher serum concentrations of interleukin-6, fibrinogen, ESR and higher CRP values than the individuals from the control group (p = 0.001, p = 0.009, p = 0.036, p = 0.009 respectively). Patients with unstable plaques structure had significantly higher concentrations of TNF-α, interleukin-6, fibrinogen, higher number of leukocytes, monocytes and higher CRP values than patients with stable plaques (p = 0.008, p = 0.049, p = 0.012, p = 0.0002, p = 0.006, p = 0.0003 respectively). No significant differences in above-mentioned parameters between the groups with stenosis < 70% and ≥ 70% were found.ConclusionsThere is a relationship between the activity of the selected inflammatory markers in serum and atherosclerotic unstable internal carotid artery stenosis. There is no relationship between serum concentration of inflammatory markers and degree of carotid artery stenosis.

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Section: Discussionmentioning

confidence: 99%

Inflammatory markers in patients with internal carotid artery stenosis

Puz¹,

Lasek–Bal²,

Ziaja³

et al. 2013

aoms

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“…In‐depth studies on the aetiology, pathogenesis and clinical treatment of CHD have identified other important pathogenic factors in addition to the traditional risk factors of smoking, hypertension, diabetes and dyslipidaemia . Since the 1990s, researchers have provided evidence that infection is one of the risk factors for atherosclerosis and thrombus formation and that systemic inflammation due to infection promotes and accelerates the initiation and progression of atherosclerosis …”

Section: Introductionmentioning

confidence: 99%

Correlation between the severity of periodontitis and coronary artery stenosis in a Chinese population

Yang

Feng

Ren

et al. 2013

Australian Dental Journal

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Background: The aim of this study was to evaluate the relationship between the severity of periodontitis and the extent and degree of coronary artery stenosis in a Chinese population. Methods: Patients (n = 853) with coronary artery stenosis confirmed by coronary angiography were eligible to take part in the study. Only subjects that were ≥60 years old, had ≥50% stenosis in at least one coronary artery, and did not have diabetes or a history of smoking were included (n = 115). After periodontal examination, including bleeding index, probing depth calculus index, plaque index and periodontal attachment loss, four groups were defined based on the severity of periodontitis: no periodontitis/gingivitis (M0, n = 19); mild periodontitis (M1, n = 27); moderate periodontitis (M2, n = 31); and severe periodontitis (M3, n = 38). The extent and degree of coronary artery stenosis was obtained by calculating the Gensini score (GS). Results: The GS was significantly greater in the M3 group compared with the M0 group. Multiple linear regression analysis revealed that probing depth and plaque index were significantly correlated with the GS. Conclusions: The extent and severity of coronary artery stenosis in Chinese patients ≥60 years old is positively correlated with the severity of periodontitis.

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“…Of these, H. pylori eradication has been reported to improve performance and increase lifespan in Alzheimer's disease patients [19], while two case reports indicated virtually complete recovery from long-term (3 years) misdiagnosed dementia/Alzheimer's disease following antifungal treatment for C. neoformans infection [20,21]. Many of these pathogens including herpes simplex, HHV-6, C. Pneumoniae, H. pylori and the periodontal pathogen, P. Gingivalis, have also been implicated in atherosclerosis [22][23][24][25], while C. neoformans infection in rabbits induces an increase in neutrophil superoxide production, plasma lipid peroxidation, and an increase in inflammatory cells, forerunners of atherosclerosis [26]. Atherosclerosis of the carotid arteries, or of the circle of Willis and leptomeningeal arteries, is a significant predictor of risk in dementia or Alzheimer's disease and correlates with Alzheimer's disease pathology [27,28].…”

Section: Introductionmentioning

confidence: 99%

Alzheimer′s Disease: APP, Gamma Secretase, APOE, CLU, CR1, PICALM, ABCA7, BIN1, CD2AP, CD33, EPHA1, and MS4A2, and Their Relationships with Herpes Simplex, C. Pneumoniae, Other Suspect Pathogens, and the Immune System

Carter

2011

International Journal of Alzheimer's Disease

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Alzheimer's disease susceptibility genes, APP and gamma-secretase, are involved in the herpes simplex life cycle, and that of other suspect pathogens (C. pneumoniae, H. pylori, C. neoformans, B. burgdorferri, P. gingivalis) or immune defence. Such pathogens promote beta-amyloid deposition and tau phosphorylation and may thus be causative agents, whose effects are conditioned by genes. The antimicrobial effects of beta-amyloid, the localisation of APP/gamma-secretase in immunocompetent dendritic cells, and gamma secretase cleavage of numerous pathogen receptors suggest that this network is concerned with pathogen disposal, effects which may be abrogated by the presence of beta-amyloid autoantibodies in the elderly. These autoantibodies, as well as those to nerve growth factor and tau, also observed in Alzheimer's disease, may well be antibodies to pathogens, due to homology between human autoantigens and pathogen proteins. NGF or tau antibodies promote beta-amyloid deposition, neurofibrillary tangles, or cholinergic neuronal loss, and, with other autoantibodies, such as anti-ATPase, are potential agents of destruction, whose formation is dictated by sequence homology between pathogen and human proteins, and thus by pathogen strain and human genes. Pathogen elimination in the ageing population and removal of culpable autoantibodies might reduce the incidence and offer hope for a cure in this affliction.

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The Role of Infection in Carotid Plaque Pathogenesis and Stability: The Clinical Evidence

Cited by 15 publications

References 0 publications

Inflammatory markers in patients with internal carotid artery stenosis

Inflammatory markers in patients with internal carotid artery stenosis

Correlation between the severity of periodontitis and coronary artery stenosis in a Chinese population

Alzheimer′s Disease: APP, Gamma Secretase, APOE, CLU, CR1, PICALM, ABCA7, BIN1, CD2AP, CD33, EPHA1, and MS4A2, and Their Relationships with Herpes Simplex, C. Pneumoniae, Other Suspect Pathogens, and the Immune System

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