Coinfection with Mycoplasma pneumoniae and Chlamydia pneumoniae in ruptured plaques associated with acute myocardial infarction.
OBJECTIVE
To study atheromas, Mycoplasma pneumoniae (M. pneumoniae), and Chlamydia pneumoniae (C. pneumoniae).


METHODS
C. pneumoniae was studied with immunohistochemistry and M. pneumoniae with in situ hybridization (ISH), in segments of coronary arteries (SCA) as follows: group A - thrombosed ruptured plaques (TRP) of 23 patients who died due to acute myocardial infarction (AMI); group B - 23 nonruptured plaques (NRP) of group A patients; group C - NRP of 11 coronary patients who did not die due to AMI; and group D - 11 SCA from patients with dilated cardiomyopathy or Chagas' disease without atherosclerosis.


RESULTS
The mean number of C. pneumoniae+ cells/400x in groups A, B, C, and D was, respectively, 3.3 +/- 3.6; 1.0 +/- 1.3; 1.2 +/- 2.4; and 0.4 +/- 0.3; and the percentage of M. pneumoniae area was, respectively, 3.9 +/- 3.5; 1.5 +/- 1.6; 0.9 +/- 0.9; and 0.4 +/- 0.2. More M. pneumoniae and C. pneumoniae were found in of group A than in group B (P<0.01). Good correlation was seen between the area of the vessel and the M. pneumoniae area in the plaque (r = 0.46; P=0.001) and between C. pneumoniae+ cells and CD4+ T lymphocytes (r = 0.42; P<0.01). The number of C. pneumoniae+ cells correlated with CD20+ B cells (r=0.48; P<0.01).


CONCLUSIONS
M. pneumoniae and C. pneumoniae are more frequently found in TRP correlate with the intensity of the inflammation and diameter of the vessel (positive remodeling).
Higuchi
Maria de Lourdes
Mde L
Instituto do Coração, Hospital das Clínicas, FMUSP, São Paulo, SP, Brasil. amplourdes@incor.usp.br
Reis
Marcia Martins
MM
Sambiase
Nádia Vieira
NV
Palomino
Suely Aparecida Pinheiro
SA
Castelli
Jussara Bianchi
JB
Gutierrez
Paulo Sampaio
PS
Aiello
Vera Demarchi
VD
Ramires
José Antonio Franchini
JA
D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000382:microbiology; D014355:Chagas Disease / Q000382:microbiology; D002690:Chlamydia Infections / Q000150:complications*; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification / Q000648:ultrastructure; D003324:Coronary Artery Disease / Q000382:microbiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification / Q000648:ultrastructure; D009203:Myocardial Infarction / Q000382:microbiology* / Q000473:pathology; D011019:Pneumonia, Mycoplasma / Q000150:complications*; D012422:Rupture, Spontaneous