Infectious–Immune Triggers of Atherosclerosis
DOI:
https://doi.org/10.31149/ijimm.v4i4.2834Keywords:
atherosclerosis, infections, inflammation, endothelial dysfunction, NLRP3 inflammasome, trained immunity, microbiota, TMAO, periodontitis, cardiovascular riskAbstract
Atherosclerosis is considered a chronic inflammatory process in which infectious agents, infection‑induced systemic inflammation, disturbances of innate and adaptive immunity, as well as microbial metabolites may play a role in its development and progression. This paper summarizes data on the association between chronic infections—including periodontitis, viral hepatitis, herpesvirus infections, and other inflammatory conditions—and an increased risk of atherosclerotic cardiovascular complications. Key pathogenetic mechanisms are discussed, including endothelial dysfunction, activation of Toll‑like receptor (TLR) signaling, foam cell formation, involvement of the NLRP3 inflammasome, trained immunity, and the influence of the gut microbiota through trimethylamine N‑oxide (TMAO) and metabolic endotoxemia. Particular attention is paid to the limited evidence of a causal relationship, as interventional studies on infection eradication have not yet demonstrated a convincing reduction in cardiovascular events. Promising therapeutic directions, including anti‑inflammatory strategies, gut microbiota modulation, and targeting the NLRP3/IL‑1β/IL‑6 axis, are also outlined.
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