ISOLATION OF CHLAMYDIA-PNEUMONIAE FROM THE CORONARY-ARTERY OF A PATIENT WITH CORONARY ATHEROSCLEROSIS

Background: Atherosclerosis is pathologically similar to a chronic inf lammatory response, Recent reports have suggested that Chlamydia pneum oniae may play a role in the pathogenesis of atherosclerosis. Objectiv e: To determine, by using various detection methods, whether C. pneumo niae is present in the coronary arteries of patients with coronary ath erosclerosis. Design: Multicenter investigation. Setting: The Jewish H ospital Heart and Lung Institute in Louisville, Kentucky, and several laboratories. Patients: 12 patients seeking heart transplantation. Mea surements: Culture for C. pneumoniae was done in HEp-2 cell monolayers . Other methods of detection included polymerase chain reaction (PCR) assay, immunocytochemistry, transmission electron microscopy, and in s itu hybridization. Results: Chlamydia pneumoniae was cultured from ath erosclerotic plaques in one patient with severe coronary artery diseas e. The organism was found in the atheromas of this patient by PCR assa y, immunocytochemistry, electron microscopy, and in situ hybridization . In addition, at least one testing method showed C. pneumoniae in cor onary artery tissue in six of nine additional patients with coronary a therosclerosis. Conclusions: This study provides direct evidence of th e presence of viable C. pneumoniae in atheromatous lesions, A chronic inflammatory response caused by a persistent infection of the coronary arteries may explain the link between C. pneumoniae and atheroscleros is.