Infection and intimal thickening: evidence from coronary arteries in children.

Abstract

Post-mortem examination in children may reveal narrowing of coronary artery diameter by up to 60% due to intimal thickening. This is statistically associated with recent or intercurrent infection. Endothelial injury is known to be caused by septicaemia, for example, and endothelial injury initiates atherogenesis. Elevation of tumour necrosis factor alpha (TNF alpha) levels is a feature of both septicaemia and atheroma, and TNF alpha can damage endothelium, stimulate platelet-derived-growth-factor (PDGF) secretion and thereby promote vascular smooth muscle cell proliferation. Episodes of infection-related endothelial damage, leading to intimal thickening followed by partial regression, may start in infancy and contribute cumulatively to the development of coronary atheroma.