A perspective on Chlamydia pneumoniae and coronary heart disease

Abstract

There is a consistent association between evidence of the presence of Chlamydia pneumoniae infection and coronary heart disease (CHD), but a causal relationship between the organism and atherogenesis has not been established (See Table 11). Since the original report in 1988 suggesting that C. pneumoniae was linked with CHD, there has been, understandably, a rather mixed response from the scientific community, including doubt, speculation, excitement and intense research. The original observations have led to numerous follow-up investigations in many countries. These included: seroepidemiological studies showing associations between anti-C. pneumoniae antibodies and CHD, positive identification of the organism within, and its culture from, atheroma; development of animal models of C. pneumoniae-induced atherogenesis; in vitro studies providing evidence of an ‘infectious’ basis for atherogenesis; and clinical intervention secondary prevention studies using antichlamydial antibiotics. The international nature of research in this field can be seen from the map in Figure 12, which highlights countries where important studies have been carried out or are ongoing.