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Infectious Burden: A New Risk Factor and Treatment Target for Atherosclerosis

机译：传染病负担：动脉粥样硬化的新危险因素和治疗目标

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Atherosclerosis is a chronic inflammatory process, and several common bacterial and viral infections have nbeen hypothesized to contribute to the inflammation of the vascular wall that leads to atherosclerosis. More recently, ninvestigators have found preliminary evidence that the aggregate burden of these chronic infections, rather than any single norganism, may contribute to atherosclerosis and risk of clinical vascular events, including ischemic stroke. This aggregate nburden of infections, which has been variably labeled “infectious burden” or “pathogen burden,” may be associated with nstroke through mechanisms independent of atherosclerosis, as well, including platelet aggregation and endothelial ndysfunction. Host factors, moreover, may interact with infectious burden to modify the risk of disease associated with nthese infections. Currently there is no commonly accepted group of organisms or method of assessing infectious burden, nand not all studies confirm an association of infection and stroke risk. Nonetheless, if infectious burden does play a role in natherosclerosis or stroke, it is plausible that preventive anti-infective treatment, such as vaccination, or antibiotics, would nreduce the risk of incident or recurrent stroke. While influenza vaccination has been recommended to prevent recurrence namong those with coronary disease, similar recommendations for stroke patients have not yet been made. Large scale nrandomized clinical trials of macrolide antibiotics for coronary patients, moreover, have been negative. Further studies are nneeded, however, to determine whether an association between infectious burden and stroke exists, and whether infectious nburden may be a target for intervention.
机译：动脉粥样硬化是一种慢性炎症过程，据推测，几种常见的细菌和病毒感染可导致导致动脉粥样硬化的血管壁发炎。最近，n研究人员发现了初步证据，表明这些慢性感染的总负担而不是任何单一的有机体可能导致动脉粥样硬化和包括缺血性中风在内的临床血管事件的风险。这种总的感染负担被可变地标记为“感染负担”或“病原体负担”，也可能通过与动脉粥样硬化无关的机制与中风相关，包括血小板聚集和内皮功能障碍。此外，宿主因素可能与感染负担相互作用，以改变与这些感染相关的疾病风险。目前，尚无公认的评估感染负担的生物体或方法，也并非所有研究都证实感染与中风风险之间存在关联。但是，如果感染负担确实在动脉粥样硬化或中风中起作用，那么预防性抗感染治疗（如疫苗接种或抗生素）将减少发生中风或复发性中风的风险，这似乎是合理的。尽管已建议在冠心病患者中接种流感疫苗以预防复发，但尚未对中风患者提出类似建议。此外，大环内酯类抗生素对冠心病患者的大规模随机临床试验是阴性的。但是，需要进一步的研究来确定感染负担和中风之间是否存在关联，以及感染负担是否可能是干预的目标。

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