CMV endothelitis as a factor in the pathogenesis of atherosclerosis

See article by Guetta et al. [8] (pages 538–546) in this issue. Although many factors that contribute to the development of atherosclerosis are known, major parts of its etiology need still to be elucidated. Since the 1970's a link between infectious disease and atherosclerotic disease has been hypothesized [1–3]. Infectious agents that are implicated in the pathogenesis of atherosclerosis include bacterial pathogens, such as Helicobacter pylori or Chlamydia pneumoniae, but also viruses are thought to play an important role [4]. Cytomegalovirus (CMV) is one of the most intense studied viruses as related to its potential role as a causative infectious agent that may contribute to the development of atherosclerosis [5]. There are several lines of evidence that CMV may be involved in atherogenesis. Firstly, more than 20 epidemiological studies show a relationship between the presence of CMV antibodies in serum and atherosclerotic disease. The odds ratio for atherosclerosis in CMV antibody positive patients in most of these studies is around 2. Although many of these studies had a relatively small sample size, may have …