REVIEW Atherosclerosis, inflammation and Chlamydia pneumoniae

Coronary heart disease is the single most common cause of illness and death in the developed world. Coronary atherosclerosis is by far the most frequent cause of ischemic heart disease, and plaque disruption with superimposed thrombosis is the main cause of the acute coronary syndromes of unstable angina, myocar-dial infarction, and sudden death. Atherosclerosis is the result of a complex interaction between blood elements, disturbed flow, and vessel wall abnormality, involving several pathological processes: inflammation, with in-creased endothelial permeability, endothelial activation, and monocyte recruitment; growth, with smooth muscle cell proliferation, migration, and matrix synthesis; de-generation, with lipid accumulation; necrosis, possibly related to the cytotoxic effect of oxidized lipid; calcifica-tion/ossification, which may represent an active rather than a dystrophic process; and thrombosis, with platelet recruitment and fibrin formation. In this review we dis-cuss these processes and the possible pathological ef-fects of Chlamydia infection and the ensuing phlogosis