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First 11 pages of thesis. - OPUS - Universität Würzburg

First 11 pages of thesis. - OPUS - Universität Würzburg

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and Porphyromonas gingivalis 19 are associated with atherosclerosis<br />

development. Chronic inflammatory disease secondary to infection, like<br />

acquired immunodeficiency syndrome (AIDS) due to infection <strong>of</strong> human<br />

immunodeficiency virus (HIV) 20 and auto immune diseases like systemic lupus<br />

erythematosus and rheumatoid arthritis also accelerate atherosclerosis<br />

development 21 .<br />

4. Lack <strong>of</strong> exercise<br />

Lack <strong>of</strong> physical exercise and a sedentary life style is an independent risk factor<br />

for various cardiovascular diseases. Regular exercise results in reduction <strong>of</strong><br />

body fat, LDL cholesterol, triglyceride levels and blood pressure and increases<br />

atheroprotective HDL cholesterol levels 22 . Physical exercise is <strong>of</strong> paramount<br />

importance as it positively influences many independent cardiovascular disease<br />

risk factors.<br />

5. Oxidative stress<br />

Increased levels <strong>of</strong> oxidants or decreased levels <strong>of</strong> anti-oxidants secondary to<br />

dyslipidemia, hypertension, diabetes and smoking are implicated in the<br />

pathogenesis <strong>of</strong> atherosclerosis. Oxidation <strong>of</strong> LDL is considered to be the<br />

critical step involved in ‘foam cell’ formation 23 . Oxidation <strong>of</strong> LDL results in many<br />

structural modifications and generation <strong>of</strong> numerous ‘oxidation specific epitopes’<br />

such as malondialdehyde (MDA)-lysines and 4-hydroxynonenal (4-HNE)–lysine’<br />

which are highly immunogenic. Immunization <strong>of</strong> mice with MDA and native LDL<br />

resulted in a significant reduction <strong>of</strong> atherosclerosis indicating the<br />

proatherosclerotic role <strong>of</strong> oxidized LDL (ox-LDL) 24 .<br />

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