RESUMO
The meta-analysis of 12 clinical research of application of antibiotics (azithromycin, roxithromycin clarithromycin, gatifloxacin) in 24 949 patients with coronary heart disease were carried out. The obtained results were shown that application of short courses of antibiotic therapy in patients with severe morphological changes in small coronary vessels were not enough effective. Contrariwise, long-term courses of antibiotic therapy could be effective in patients with initial lesions of blood vessels and presence of chronic infections.
Assuntos
Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Infecções por Chlamydophila/tratamento farmacológico , Claritromicina/uso terapêutico , Doença das Coronárias/tratamento farmacológico , Fluoroquinolonas/uso terapêutico , Infecções por Helicobacter/tratamento farmacológico , Roxitromicina/uso terapêutico , Antibacterianos/farmacologia , Azitromicina/farmacologia , Infecções por Chlamydophila/complicações , Infecções por Chlamydophila/mortalidade , Chlamydophila pneumoniae/efeitos dos fármacos , Chlamydophila pneumoniae/crescimento & desenvolvimento , Claritromicina/farmacologia , Doença das Coronárias/complicações , Doença das Coronárias/mortalidade , Método Duplo-Cego , Esquema de Medicação , Feminino , Fluoroquinolonas/farmacologia , Gatifloxacina , Infecções por Helicobacter/complicações , Infecções por Helicobacter/mortalidade , Helicobacter pylori/efeitos dos fármacos , Helicobacter pylori/crescimento & desenvolvimento , Humanos , Masculino , Placebos , Roxitromicina/farmacologia , Taxa de Sobrevida , Resultado do TratamentoRESUMO
The estimation data of contamination by separate groups of microorganisms and dependence of the microbial content level upon TLR4 gene 896A/G polymorphism in 20 samples of atherosclerotic lesions in coronary arteries has been presented. The presence of TLR4 gene polymorphic allele G in the individual genotype determines the increased contamination of atherosclerotic plaque tissues by the representatives of the following genera: Lactobacillus sp., Enterobacterium sp., Sneathia sp./Leptotrihia sp./Fusobacterium sp., Mobiluncus sp./Corynebacterium sp., Peptostreptococcus sp. The emergence of new correlation pairs with participation of Lachnobacterium sp./Corynebacterium sp. among the carriers of G allele has been revealed via the intragroup correlation analysis. The obtained results confirm the possible involvement of the represented groups of microorganisms in the pathogenesis of atherosclerosis and the role of the TLR4 gene polymorphic variant G in the increased microbial contamination of the coronary arteries tissues.
Assuntos
Aterosclerose/genética , Aterosclerose/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Placa Aterosclerótica/genética , Placa Aterosclerótica/microbiologia , Receptor 4 Toll-Like/genética , Alelos , Aterosclerose/metabolismo , Aterosclerose/patologia , Autopsia , Vasos Coronários/metabolismo , Vasos Coronários/microbiologia , Vasos Coronários/patologia , Frequência do Gene , Predisposição Genética para Doença , Bactérias Gram-Negativas/classificação , Bactérias Gram-Negativas/genética , Bactérias Gram-Positivas/classificação , Bactérias Gram-Positivas/genética , Humanos , Placa Aterosclerótica/metabolismo , Placa Aterosclerótica/patologia , Reação em Cadeia da Polimerase , Polimorfismo de Nucleotídeo ÚnicoRESUMO
AIM: Establishment of presence of periodonto-pathogenic microorganisms in atherosclerosis plaque and surrounding tissues, and possible relation of development of atherosclerosis and TLR4 gene Asp299Gly polymorphism in ischemic heart disease patients (IHD). MATERIALS AND METHODS: Samples of coronary vessels obtained during autopsy of 31 individuals deceased from IHD and 5 individuals deceased due to reasons not related with IHD were studied. PCR was used to determine DNA of the microorganisms. TLR4 gene polymorphic segment was amplified by using specific primers. RESULTS: Analysis of coronary vessel atherosclerotic plaques revealed presence of the studied periodontopathogenic microorganisms in 83.9% of cases. The most frequently detected were Porphyromonas gingivalis (64.5%), Treponema denticola (41.9%), Actinobacillus actinomycetemcomitans (32.3%), less frequently--Bacteroides forsythus and Prevotella intermedia (12.9% and 6.5% respectively). In 51.6% of cases 2 or more microorganisms were detected. Only in 11.1% ofcoronary artery samples, with plaques containing microorganisms, the microorganisms were detected in undamaged tissues. Patients deceased from IHD had TLR4 gene 299Gly allele significantly more frequently. CONCLUSION: The studied periodontopathogenic microorganisms can play an important role in the pathogenesis of atherosclerotic injury of coronary arteries in IHD. The presence of TLR4 gene allele 299Gly significantly contributes to these processes.