http://www.ncbi.nlm.nih.gov/pubmed/21060340
Abstract
The occurrence of
stroke in populations is incompletely explained by traditional vascular
risk factors. Data from several case-control studies and one large study
using case series methodology indicate that recent infection is a
temporarily acting, independent trigger factor for ischemic stroke. Both
bacterial and viral infections, particularly respiratory tract
infections, contribute to this association. A causal role for infection
in stroke is supported by a graded temporal relationship between these
conditions, and by multiple pathophysiological pathways linking
infection and inflammation, thrombosis, and stroke. Furthermore,
observational studies suggest that influenza vaccination confers a
preventive effect against stroke. Case-control and prospective studies
indicate that chronic infections, such as periodontitis, chronic
bronchitis and infection with Helicobacter pylori, Chlamydia pneumoniae
or Cytomegalovirus, might increase stroke risk, although considerable
variation exists in the results of these studies, and methodological
issues regarding serological results remain unresolved. Increasing
evidence indicates that the aggregate burden of chronic and/or past
infections rather than any one single infectious disease is associated
with the risk of stroke. Furthermore, genetic predispositions relating
to infection susceptibility and the strength of the inflammatory
response seem to co-determine this risk. Here, we summarize and analyze
the evidence for common acute and chronic infectious diseases as stroke
risk factors.
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