Chlamydia Atherosclerosis Lesion (eBook)

Dr Allan Shor is an anatomical pathologist who discovered Chlamydia pneumoniae germs in atheroma lesions and described the features of a Chlamydia pneumoniae atheroma lesion of the arteries. He is a world authority of this very specialized field of pathology of Chlamydia pneumoniae and atherosclerosis lesions and possesses a collection of unique and extensive micrographs and electron micrographs of the disease: the result of many years of microscopic and electron microscopic examination of many tens of thousands of atheroma lesions. Dr Allan Shor has written many peer reviewed articles in prominent international journals and given many international invited lectures on the subject.

Preface 7
Contents 9
Introduction 13
1.1. Killer Germs That Clog Arteries 13
The Germ’s Story 15
2.1. A Life of Infection and Destruction 15
The Deadly Disease 18
3.1. A Very Common Disease 18
3.2. A Little Bit of History 20
3.3. Research 22
3.4. Cholesterol 22
3.5. Other Components 23
3.6. Molecular Biology of the Lesion 24
3.7. The Age of Statistics 24
3.8. Animal Studies 25
3.9. Modern View of the Lesion 25
Atheroma Gruel 29
4.1. Study of Fatty Gruel That Clogs Arteries 29
4.2. Electron Microscope 31
4.3. Electron Microscopic Features of Atheroma Gruel 32
Discovery 41
5.1. Does Atheroma Gruel Consist of Fat or Germs? 41
5.2. Which Germ? 42
5.3. A 43
Germ 43
Which Chlamydia Species? 47
6.1. Some Unique Features of the Chlamydia Germ in Atheroma 47
6.2. Not Conventional Chlamydia Species 48
6.3. A New Chlamydia Species 49
6.4. Other Chlamydia Species 53
Identification of the Atheroma Germ 55
7.1. Attempts at Identification of the Germ 55
7.2. Positive Identification of Chlamydia TWAR 57
7.3. Methods of Identification 57
Publications, Presentations, and Confirmation 60
8.1. Publications 60
8.2. Presentations 61
8.3. Confirmation 62
8.4. Possible Special Strain of Chlamydia pneumoniae 62
Chlamydia Are Inherent Components of Atheroma 66
9.1. Serology Not Helpful 66
9.2. Previous Journal Articles on Atheroma Contain Pictures of Unrecognized Chlamydia Germs 67
9.3. Persons with Congenital Raised Cholesterol Contain Chlamydia pneumoniae Germs in Atheroma 68
9.4. Are There Other Germs in Atheroma? 69
Do Chlamydia Germs Cause Atherosclerosis? 72
10.1. Determining Causality 72
10.2. Statistical Criteria 73
10.3. Koch’s Postulates 74
10.4. Does Eradication of Germ Prove Causality? 74
10.5. No Disease Without Causal Agent 75
Pathological Lesion Diagnosis 76
11.1. Lesion Examination 76
11.2. Lesion Diagnosis 77
11.3. Inability to Diagnose Atheroma Lesion 77
Study of Atheroma Lesions 79
12.1. Steps in Atheroma Lesion Formation 79
12.2. Aspects Requiring Reexamination 80
12.3. Addressing the Problem of Atheroma Lesion Formation 80
New Findings Concerning the Initial Lesion 83
13.1. Initial Lesion 83
13.2. Primary Muscle Damage 84
13.3. Chlamydia Cause Muscle Cell Damage 92
Fatty Streak Lesion 94
14.1. Macrophage Infiltration 94
14.2. Macrophages Phagocytose Fat, Germs, and Muscle 94
14.3. Macrophage Reaction Resulting from Germs and Muscle Damage 99
Formation of Fibronecrotic Plaque 101
15.11 Formation of Atheroma Gruel 101
15.2. Ceroid or Blighted Chlamydia Vacuoles? 107
15.3. Cholesterol Crystallization 110
15.4. Late Sequelae: Fibrosis, Calcification, and Angiogenesis 113
Interpretation of Lesion 116
16.1. Another Way to Look at the Lesion 116
16.2. Assessment of Evidence 121
16.3. What Do We Call the Lesion? 123
Confirmatory Molecular Biological Studies 124
17.1. Is Lymphocytic Infiltrate Caused by 124
17.2. Intimal Smooth Muscle Cell Damage 125
17.3. Monocyte and Macrophage Infiltrate 125
17.4. Endothelial Changes 126
17.5. Collagen Formation 126
Derivation of Lipid in Lesion 129
18.1. Atheroma Lipid 129
18.2. Chlamydia Lipid 131
18.3. Cholesterol: Friend or Foe? 133
Acceptance 136
19.1. Old Ideas Do Not Change 136
19.2. Rejection of New Ideas 137
Diagnosis of Atheroma Lesions 139
20.1. Serology 140
20.2. Heat Shock Protein 140
20.3. C-Reactive Protein 140
20.4. Detection of Chlamydia in White Blood Cells and Blood 141
20.5. Other Possible Tests 141
20.6. Pathological Diagnosis 141
20.7. Chlamydia Inclusion Bodies 141
20.8. Electron Microscopy 142
20.9. Immunohistochemical Detection 142
20.10. Polymerase Chain Reaction 142
20.11. Culture 142
Treatment 144
21.1. Antibiotic Sensitivity 145
21.2. What Happens to the Lesion? 146
21.3. Does the Lesion Change in Size? 146
21.4. Does the Lesion Change in Character? 147
Pathological Study 149
22.1. Eradication of Germ 150
22.2. Size of Lesion 151
22.3. Stage of Lesion 151
22.4. Decrease in Inflammation 151
22.5. Fibrosis and Scar Formation 151
22.6. Regeneration 154
22.7. Does Treatment Increase Healing? 154
Other Studies 156
23.1. Animal Studies 156
23.2. Retrospective Studies 156
23.3. Secondary Prevention Trials 157
23.4. Meta-Analysis 159
23.5. Relevance of Clinical Trials 159
23.6. Unconsidered Aspects 159
23.7. Noncardiac Treatment Trials 160
What Do We Know About Treatment of Atheroma Lesions? 163
24.1. Physiology of the Heart 163
24.2. What Causes a Heart Attack? 164
24.3. Atherosclerosis Is Not the Same as Ischemic Heart Disease 165
Other Treatment Possibilities 167
25.1. Statins 167
25.2. Aspirin 168
25.3. Antihypertensive Agents 169
25.4. New Innovative Agents 169
25.5. Immunization 170
Conclusion 172
Glossary of Terms 173
Index 175