Document Detail

CMV and transplant-related coronary atherosclerosis: an immunohistochemical, in situ hybridization, and polymerase chain reaction in situ study.
MedLine Citation:
PMID:  10697275     Owner:  NLM     Status:  MEDLINE    
Accelerated graft coronary atherosclerosis is the main obstacle to long-term survival in patients who have had a heart transplant. A possible involvement of the human cytomegalovirus (HCMV) in this type of coronary atherosclerosis has been postulated by many authors but has not been definitively demonstrated. In an attempt to clarify the role of HCMV infection in the pathogenesis of this complication, we looked for in situ antigens or DNA of HCMV in 30 coronary artery segments obtained at necropsy from patients who had undergone orthotopic cardiac transplantation at the São Paulo Heart Institute. We tried to correlate these HCMV markers with the presence of inflammation and/or atherosclerosis in histologic sections. The patients were grouped as follows: GI, less than 170 days of graft survival and absent/mild atherosclerosis; GII, more than 170 days of graft survival and absent/mild atherosclerosis; GIII, more than 170 days of graft survival and severe/moderate atherosclerosis (170 days was the shortest graft survival time associated with atherosclerosis). The search for HCMV genome and antigens in the coronary artery sections was performed using immunohistochemistry, in situ hybridization, and polymerase chain reaction in situ techniques. Immunohistochemistry and in situ hybridization revealed no evidence of HCMV in all 30 cases. Polymerase chain reaction in situ revealed scarce HCMV-positive lymphocytes in two cases (one each from GI and GIII) located in the adventitial layer. These findings preclude a direct role for the HCMV in the pathogenesis of accelerated graft coronary atherosclerosis. However, the possibility of an indirect effect of the virus, such as an immune-mediated inflammatory response by the host that increases the expression of histocompatibility antigens, leading to tissue injury, cannot be excluded.
N V Sambiase; M L Higuchi; G Nuovo; P S Gutierrez; A I Fiorelli; D E Uip; J A Ramires
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc     Volume:  13     ISSN:  0893-3952     ISO Abbreviation:  Mod. Pathol.     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-03-17     Completed Date:  2000-03-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8806605     Medline TA:  Mod Pathol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  173-9     Citation Subset:  IM    
Laboratory of Pathology, University of São Paulo Medical School, Brazil.
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MeSH Terms
Antigens, Viral / analysis
Coronary Artery Disease / etiology*,  pathology,  virology
Coronary Vessels / pathology,  virology
Cytomegalovirus / genetics,  immunology,  pathogenicity*
Cytomegalovirus Infections / complications*
DNA Primers / chemistry
DNA, Viral / analysis
Heart Transplantation / adverse effects*
Immunoenzyme Techniques
In Situ Hybridization
Middle Aged
Polymerase Chain Reaction
Reg. No./Substance:
0/Antigens, Viral; 0/DNA Primers; 0/DNA, Viral

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