title: Detection of enterovirus, cytomegalovirus, and Chlamydia pneumoniae in atheromas.
abstract: To investigate the presence of infectious agents in human atherosclerotic arterial tissues. Atherosclerotic plaques were removed from 128 patients undergoing carotid endarterectomy or other bypass procedures for occlusive disease, and from twenty normal arterial wall samples, obtained from transplant donors with no history of diabetes, hypertension, smoking, or hyperlipidemia. Using the polymerase chain reaction (PCR) or reverse transcription-PCR, these samples were analyzed for the presence of Chlamydia pneumoniae, cytomegalovirus, enterovirus, adenovirus, herpes simplex viruses types 1 and 2, and Epstein-Barr virus. The amplicons were then sequenced, and phylogenetic analyses were performed. Enteroviral RNA was found in 22 of 128 atherosclerotic vascular lesions (17.2%), and C. pneumoniae and cytomegalovirus were each found in 2 samples (1.6%). In contrast, adenovirus, herpes simplex viruses, and Epstein-Barr virus were not identified in any of the atherosclerotic samples. Enterovirus was detected in 6/24 (25.0%) aortas, 7/33 (21.2%) carotid arteries, 6/40 (15.0%) femoral arteries, and 3/31 (9.7%) radial arteries of patients with chronic renal failure. There were no infectious agents detected in any of the control specimens. Using phylogenetic analysis, the enterovirus isolates were clustered into 3 groups, arranged as echovirus 9 and coxsackieviruses B1 and B3. Enteroviral RNA was detected in 17.2% of atherosclerotic plaques, but was not observed in any of the control specimens. This suggests a connection between enteroviral infection and atherosclerosis. These findings differ from those of other studies, which found more frequent incidence of C. pneumoniae and cytomegalovirus infection in atherosclerotic plaques.
authors.affiliation: Department of Vascular Surgery, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Tae Won
authors.initials: TW
authors.lastname: Kwon
authors.forename: Do Kyun
authors.initials: DK
authors.lastname: Kim
authors.forename: Jeong Sook
authors.initials: JS
authors.lastname: Ye
authors.forename: Won Joo
authors.initials: WJ
authors.lastname: Lee
authors.forename: Mi Sun
authors.initials: MS
authors.lastname: Moon
authors.forename: Chul Hyun
authors.initials: CH
authors.lastname: Joo
authors.forename: Heuiran
authors.initials: H
authors.lastname: Lee
authors.forename: Yoo Kyum
authors.initials: YK
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000382:microbiology; D001161:Arteriosclerosis / Q000453:epidemiology / Q000382:microbiology*; D002339:Carotid Arteries / Q000382:microbiology; D016993:Chlamydophila pneumoniae / Q000235:genetics / Q000302:isolation & purification*; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification*; D004770:Enterovirus / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D005263:Femoral Artery / Q000382:microbiology; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D017534:Radial Artery / Q000382:microbiology