Coinfection with Mycoplasma pneumoniae and Chlamydia pneumoniae in ruptured plaques associated with acute myocardial infarction

Arq Bras Cardiol. 2003 Jul;81(1):12-22, 1-11. doi: 10.1590/s0066-782x2003000900001. Epub 2003 Jul 31.
[Article in English, Portuguese]

Abstract

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).

Conclusion: 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).

MeSH terms

  • Aged
  • Cardiomyopathy, Dilated / microbiology
  • Chagas Disease / microbiology
  • Chlamydia Infections / complications*
  • Chlamydophila pneumoniae / isolation & purification
  • Chlamydophila pneumoniae / ultrastructure
  • Coronary Artery Disease / microbiology*
  • Coronary Artery Disease / pathology
  • Female
  • Humans
  • Male
  • Mycoplasma pneumoniae / isolation & purification
  • Mycoplasma pneumoniae / ultrastructure
  • Myocardial Infarction / microbiology*
  • Myocardial Infarction / pathology
  • Pneumonia, Mycoplasma / complications*
  • Rupture, Spontaneous