Human cytomegalovirus infection and coronary heart disease: a systematic review

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Abstract

Background

Human cytomegalovirus (HCMV) infection is closely associated with coronary heart disease.

Main body of the abstract

In 1987, Adam et al. were the first to report an association between HCMV infection and atherosclerosis (AS), and later, many serum epidemiology and molecular biology studies showed that HCMV-infected endothelial cells play an important role in the development of AS. As patients with HCMV are generally susceptible to coronary heart disease, and with the increasing elderly population, a review of recent studies focusing on the relationships of HCMV infection and coronary heart disease is timely and necessary.

Short conclusion

The role of HCMV infection in the development of AS needs further study, since many remaining issues need to be explored and resolved. For example, whether HCMV promotes the development of coronary AS, and what the independent factors that lead to coronary artery AS by viral infection are. A comprehensive understanding of HCMV infection is needed in order to develop better strategies for preventing AS.

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Most cited references 123

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Role of endothelial dysfunction in atherosclerosis.

J Davignon (2004)

As the major regulator of vascular homeostasis, the endothelium exerts a number of vasoprotective effects, such as vasodilation, suppression of smooth muscle cell growth, and inhibition of inflammatory responses. Many of these effects are largely mediated by nitric oxide, the most potent endogenous vasodilator. Nitric oxide opposes the effects of endothelium-derived vasoconstrictors and inhibits oxidation of low-density lipoprotein. A defect in the production or activity of nitric oxide leads to endothelial dysfunction, signaled by impaired endothelium-dependent vasodilation. Accumulating evidence suggests that endothelial dysfunction is an early marker for atherosclerosis and can be detected before structural changes to the vessel wall are apparent on angiography or ultrasound. Many of the risk factors that predispose to atherosclerosis can also cause endothelial dysfunction, and the presence of multiple risk factors has been found to predict endothelial dysfunction. A number of clinical trials have shown that 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) improve endothelial dysfunction in patients with coronary risk factors beyond what could be attributed to their impact on plasma lipids. Studies have elucidated several possible mechanisms by which statin therapy may improve endothelial dysfunction, including upregulation of nitric oxide production or activity and reduction of oxidative stress.

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C-reactive protein and the prediction of cardiovascular events among those at intermediate risk: moving an inflammatory hypothesis toward consensus.

Paul Ridker (2007)

Over 20 large-scale prospective studies show that the inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) is an independent predictor of future cardiovascular events that additionally predicts risk of incident hypertension and diabetes. In many studies, the relative impact of hsCRP is at least as large as that individually of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, blood pressure, or smoking, and knowledge of hsCRP correctly reclassifies a substantial proportion of "intermediate-risk" individuals into clinically relevant higher- or lower-risk categories. Other studies show the relative benefit of statins to be greater among those with increased hsCRP and that achieved hsCRP levels after statin therapy predict recurrent event rates as much as achieved levels of low-density lipoprotein cholesterol. Nonetheless, it remains controversial whether the time has come to modify traditional algorithms used for global risk detection. As described here, 6 areas of controversy regarding hsCRP are resolvable with a consensus position that focuses in primary prevention on selective use among individuals with 5% to 20% 10-year risk as estimated by Adult Treatment Panel III, and focuses in secondary prevention on high-risk patients being treated with statin therapy. Forthcoming trial data could expand or contract this "screen selectively" policy, and investigators should be open to the possibility that second-generation inflammatory biomarkers may be developed that supplant hsCRP altogether. In the meantime, however, this consensus position on hsCRP should be one to which both advocates and critics of the inflammatory hypothesis of atherosclerosis can adhere because it is one that can immediately improve patient care.

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Human cytomegalovirus induces systemic immune activation characterized by a type 1 cytokine signature.

F. Bemelman, Ineke J M ten Berge, C. J. S. Young … (2010)

Mechanisms underlying the onset and perpetuation of chronic immune activation in individuals without overt infectious or autoimmune diseases are unclear. Cytomegalovirus (CMV) is a persistent virus that induces a permanent increase of highly differentiated, interferon-gamma-secreting effector T cells. We hypothesized that, because of this increase, CMV also induces a systemic inflammatory response. We measured acute phase proteins, cytokines, and chemokines in serum samples from renal transplant recipients who developed a primary CMV infection and healthy CMV serum-positive or -negative individuals. Primary CMV infection induced a clear proinflammatory response that was maintained during latency. This response was characterized by increased levels of acute phase proteins, such as serum amyloid-A and C-reactive protein, and type 1 cytokines, such as interleukin-18, interferon-inducible protein-10, and interferon-gamma. This continuous activation of the immune system may play a role in the pathogenesis of chronic allograft rejection and potentially contribute to the acceleration of chronic diseases.

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Author and article information

Contributors

Yu Du: duyu-wfmc@outlook.com

Guangxue Zhang: rainguy@163.com

Zhijun Liu:

ORCID: http://orcid.org/0000-0003-2323-462X

zhijun.liu@wfmc.edu.cn

Journal

Journal ID (nlm-ta): Virol J

Journal ID (iso-abbrev): Virol. J

Title: Virology Journal

Publisher: BioMed Central (London )

ISSN (Electronic): 1743-422X

Publication date (Electronic): 6 February 2018

Publication date PMC-release: 6 February 2018

Publication date Collection: 2018

Volume: 15

Electronic Location Identifier: 31

Affiliations

[1 ]ISNI 0000 0004 1790 6079, GRID grid.268079.2, Department of Microbiology, , Weifang Medical University, ; Weifang, 261053 China

[2 ]Department of Clinical Laboratory, Shandong Qingzhou Rongjun Hospital, Qingzhou, 262500 China

Author information

Zhijun Liu http://orcid.org/0000-0003-2323-462X

Article

Publisher ID: 937

DOI: 10.1186/s12985-018-0937-3

PMC ID: 5801777

PubMed ID: 29409508

SO-VID: 498e6925-e44a-45d4-bc7b-28134b4817e1

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 6 June 2017

Date accepted : 18 January 2018

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;

Award ID: 81471048

Award Recipient : Zhijun Liu

Funded by: Natural Science Foundation of Shandong Province

Award ID: ZR2012HL42

Award Recipient : Zhijun Liu

Funded by: Project of Shandong Province Higher Educational Science and Technology Program

Award ID: J12LK01

Award Recipient : Zhijun Liu

Funded by: Doctoral Scientific Research Foundation of Weifang Medical University

Award ID: 2017BSQD01

Award Recipient : Zhijun Liu

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ScienceOpen disciplines: Microbiology & Virology

Keywords: human cytomegalovirus,coronary heart disease,infection

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ScienceOpen disciplines: Microbiology & Virology

Keywords: human cytomegalovirus, coronary heart disease, infection

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Human cytomegalovirus infection and coronary heart disease: a systematic review

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Abstract

Background

Main body of the abstract

Short conclusion

Related collections

Decoding Infection and Transmission

Most cited references 123

Role of endothelial dysfunction in atherosclerosis.

C-reactive protein and the prediction of cardiovascular events among those at intermediate risk: moving an inflammatory hypothesis toward consensus.

Human cytomegalovirus induces systemic immune activation characterized by a type 1 cytokine signature.

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Funding

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Comments

Comment on this article

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Cited by 20

Most referenced authors 1,275