Published online Mar 26, 2015. doi: 10.4330/wjc.v7.i3.134
Peer-review started: June 24, 2014
First decision: June 24, 2014
Revised: October 4, 2014
Accepted: November 27, 2014
Article in press: December 1, 2014
Published online: March 26, 2015
Processing time: 113 Days and 15.3 Hours
Though a century old hypothesis, infection as a cause for atherosclerosis is still a debatable issue. Epidemiological and clinical studies had shown a possible association but inhomogeneity in the study population and study methods along with potential confounders have yielded conflicting results. Infection triggers a chronic inflammatory state which along with other mechanisms such as dyslipidemia, hyper-homocysteinemia, hypercoagulability, impaired glucose metabolism and endothelial dysfunction, contribute in pathogenesis of atherosclerosis. Studies have shown a positive relations between Cytotoxic associated gene-A positive strains of Helicobacter pylori and vascular diseases such as coronary artery disease and stroke. Infection mediated genetic modulation is a new emerging theory in this regard. Further large scale studies on infection and atherosclerosis focusing on multiple pathogenetic mechanisms may help in refining our knowledge in this aspect.
Core tip: Though a century old hypothesis, infection as a cause of atherosclerosis is still a debatable issue. Clinical and epidemiological studies had shown a possible association, however in-homogeneity in the study population and methodology has yielded conflicting results. We performed a literature search on MEDLINE electronic database using keywords such as Helicobacter pylori (H. pylori), infection, atherosclerosis, coronary artery disease, myocardial infarction, stroke, cerebro-vascular disease and peripheral arterial disease using MeSH terms, to review this subject. The association between H. pylori and atherosclerosis is not strong and a causal role is not yet established. Large scale studies on infection and atherosclerosis focusing on multiple pathogenetic mechanisms may help in refining our knowledge in this aspect.