Atherosclerosis microbiome: upcoming target for vaccine and drug development

Abstract

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in adults and is one critical area of the medical sciences. Atherosclerosis is the main underlying pathology and is characterized by chronic inflammation of the arterial walls. The current treatment modalities for CVD target hypertension, hyperlipidemia and hemostasis, and suppress inflammation without directly addressing the origin of inflammation. Thus, many individuals with multiple classic risk factors for CVD do not experience acute ischemic events. Moreover, myocardial infarction and stroke continue to occur in up to two-thirds of all patients. Because many cardiovascular events have not been explained by genetics or other risk factors, and multiple epidemiologic studies have consistently suggested an infectious component, the introduction of entirely novel approaches for diagnostics and treatment that target infections are acutely needed. These complementary novel approaches addressing additional manageable risk factors such as infections will be based on the concept of personalized medicine to control CVD and achieve longevity, while also increasing the quality of life. There are a variety of avenues that could enable such novel approaches. These focus on the discovery and characterization of the infective component of atherosclerosis, the atherosclerosis microbiome. Specifically, we provide an update of the latest developments in the oral microbiome and its relation to CVD.

Keywords

Cardiovascular disease / atherosclerosis / stroke / inflammation / bacterial infection / periodontitis / periodontal pathogens / atheroma / Porphyromonas gingivalis

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