title: Persistent Chlamydia pneumoniae infection of cardiomyocytes is correlated with fatal myocardial infarction.
abstract: Acute myocardial infarction (AMI) associated with unfavorable prognosis is likely to be the consequence of a diffuse active chronic inflammatory process that destabilizes the whole coronary tree and myocardium, suggesting a possible common causal agent underlying both conditions. The main objective of this study was to investigate whether Chlamydia pneumoniae (CP) infection occurred beyond the coronary plaques, namely in the myocardium of individuals who died of AMI. The presence of CP cell wall antigen (OMP-2) and CP-HSP60 was investigated in the myocardium and coronary plaques of 10 AMI and 10 age-matched control patients by immunohistochemistry, electron microscopy, and molecular biology. OMP-2 antigens were found in the unaffected myocardium of 9 of 10 AMI patients. Conversely, only 1 of 10 control patients exhibited a positive staining for CP. Moreover, OMP-2 and CP-HSP60 were detected in the whole coronary tree. CP presence was strongly associated with a T-cell inflammatory infiltrate. Our results suggest that CP may underlie both coronary and myocardial vulnerabilities in patients who died of AMI and corroborate the notion that CP may act by reducing cardiac reserves, thus worsening the ischemic burden of myocardium.
authors.affiliation: Cattedra di Anatomia ed Istologia Patologica, Dipartimento di Biopatologia e Diagnostica per Immagini, Università di Roma Tor Vergata, Via Montpellier 1, Rome, Italy. spagnoli@uniroma2.it
authors.forename: Luigi Giusto
authors.initials: LG
authors.lastname: Spagnoli
authors.forename: Sabina
authors.initials: S
authors.lastname: Pucci
authors.forename: Elena
authors.initials: E
authors.lastname: Bonanno
authors.forename: Antonio
authors.initials: A
authors.lastname: Cassone
authors.forename: Fabiola
authors.initials: F
authors.lastname: Sesti
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ciervo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mauriello
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001425:Bacterial Outer Membrane Proteins / Q000032:analysis; D018834:Chaperonin 60 / Q000032:analysis; D002690:Chlamydia Infections / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D016993:Chlamydophila pneumoniae; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000382:microbiology* / Q000401:mortality / Q000473:pathology; D032383:Myocytes, Cardiac / Q000382:microbiology / Q000473:pathology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D016176:T-Lymphocyte Subsets / Q000473:pathology
chemical_list: D001425:Bacterial Outer Membrane Proteins; D018834:Chaperonin 60; C063931:Omp2 protein, bacteria