title: Do Archaea and bacteria co-infection have a role in the pathogenesis of chronic chagasic cardiopathy?
abstract: Chronic cardiopathy (CC) in Chagas disease is a fibrotic myocarditis with C5b-9 complement deposition. Mycoplasma and Chlamydia may interfere with the complement response. Proteolytic enzymes and archaeal genes that have been described in Trypanosoma cruzi may increase its virulence. Here we tested the hypothesis that different ratios of Mycoplasma, Chlamydia and archaeal organisms, which are frequent symbionts, may be associated with chagasic clinical forms.
  
  
  METHODS
  eight indeterminate form (IF) and 20 CC chagasic endomyocardial biopsies were submitted to in situ hybridization, electron and immunoelectron microscopy and PCR techniques for detection of Mycoplasma pneumoniae (MP), Chlamydia pneumoniae(CP), C5b-9 and archaeal-like bodies.
  
  
  RESULTS
  MP and CP-DNA were always present at lower levels in CC than in IF (p < 0.001) and were correlated with each other only in CC. Electron microscopy revealed Mycoplasma, Chlamydia and two types of archaeal-like bodies. One had electron dense lipid content (EDL) and was mainly present in IF. The other had electron lucent content (ELC) and was mainly present in CC. In this group, ELC correlated negatively with the other microbes and EDL and positively with C5b-9. The CC group was positive for Archaea and T. cruzi DNA. In conclusion, different amounts of Mycoplasma, Chlamydia and archaeal organisms may be implicated in complement activation and may have a role in Chagas disease outcome.
authors.affiliation: Laboratório de Anatomia Patológica, Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. anplourdes@incor.usp.br
authors.forename: Maria de Lourdes
authors.initials: Mde L
authors.lastname: Higuchi
authors.forename: Joyce
authors.initials: J
authors.lastname: Kawakami
authors.forename: Renata
authors.initials: R
authors.lastname: Ikegami
authors.forename: Maysa Beatriz Mandetta
authors.initials: MB
authors.lastname: Clementino
authors.forename: Flavio M
authors.initials: FM
authors.lastname: Kawamoto
authors.forename: Marcia M
authors.initials: MM
authors.lastname: Reis
authors.forename: Edimar
authors.initials: E
authors.lastname: Bocchi
mesh_terms: D000942:Antigens, Bacterial / Q000032:analysis; D001105:Archaea / Q000302:isolation & purification*; D001706:Biopsy; D002598:Chagas Cardiomyopathy / Q000382:microbiology* / Q000473:pathology; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification*; D002908:Chronic Disease; D015938:Complement Membrane Attack Complex / Q000032:analysis*; D006801:Humans; D017403:In Situ Hybridization; D008854:Microscopy, Electron; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction
chemical_list: D000942:Antigens, Bacterial; D015938:Complement Membrane Attack Complex