Chlamydia pneumoniae and Cardiovascular Disease: Current Perspectives for the Clinician

Chlamydia (Chlamydophila) pneumoniae (CP) causes acute respiratory infections in humans and has been associated with coronary artery disease (CAD). This association has been shown in seroepidemiologic studies and by direct detection of the organism in atherosclerotic lesions. More recent prospective and larger seroepidemiological studies suggest that there may be only a weak link between elevated antibodies and immune complexes to CP and CAD. Animal models of atherosclerosis have been used to study the role of CP in the initiation and progression of atherogenesis. Different immunological and inflammatory pathways linking atherogenesis and infection have been investigated in vitro. Clinical trials failed to demonstrate benefits from the use of antibiotic treatment in patients suffering from CAD and therefore antibiotics cannot be recommended in general at present. This paper reviews the evidence for CP infection as a contributing factor to atherogenesis, seroepidemiological and histopathologic studies including animal models and provides an update of current clinical trials.