Special Section Future Trendsin Vaccination: Is cardiovascular disease preventable by vaccination?

Abstract

The possibility of using vaccination as a tool in the prevention of atherosclerotic disease was opened by the findings that infection with Chlamydia pneumoniae was an independent risk factor for cardiovascular disease, including acute myocardial infarction. Since this finding, data have accumulated confirming the initial epidemiological association and demonstrating the presence of C. pneumoniae and/or its components in vascular lesions. Recent intervention trials with antimicrobial drugs have furthermore suggested a pathogenetic relationship. The role of C. pneumoniae needs, however, to be further confirmed before deciding on the use of a possible vaccine. At present, a vaccine for C. pneumoniae is not available but development is ongoing. The task is far from easy: the intracellular bacteria cannot be reached by antibodies, and the stimulation of CDS' T cells required for protection is difficult with a nonliving vaccine. On the other hand, recent advances in biotechnology, including the sequence of the full genome of C. pneumoniae, provide unique tools for the work. With enough interest in the development of a C. pneumoniae vaccine the first clinical trials could be expected in several years' time. They will, however, have to be extensive in order to ascertain the safety of such a new type of vaccine intended for use in populations in which many have already been infected with the bacteria and many are chronic carriers. Who should be vaccinated is a question to be considered at that point.

Key Words:

• acute myocardial infarction
• cardiovascular disease
• Chlamydia pneumoniae
• vaccine