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Master's Dissertation
DOI
10.11606/D.9.2017.tde-22092017-110130
Document
Author
Full name
Renata Melo de Assis
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2008
Supervisor
Committee
Hirata, Mario Hiroyuki (President)
Gomes, Ligia Ferreira
Rezende, Adriana Augusto de
Title in Portuguese
Possível envolvimento da Chlamydia pneumoniae e Mycoplasma pneumoniae na resposta inflamatória da aterosclerose
Keywords in Portuguese
Arteriosclerose
Aterosclerose
Bioquímica clínica
Chlamydia pneumoniae
Imunohistoquímica
Mycoplasma pneumoniae
PCR em tempo real
Receptores Toll-like
Abstract in Portuguese
A aterosclerose é um processo complexo, multifatorial que ainda não está totalmente esclarecido. Foi proposto que a resposta imune mediada por processos infecciosos e/ou inflamatórios influencia na patogênese de lesões ateroscleróticas. Os receptores TolI-likes (TLRs) estão envolvidos na resposta inata e em outros eventos fisiológicos através da interação com seus ligantes endógenos e exógenos e talvez envolvidos no processo aterogênico. Tem por objetivo analisar a expressão dos receptores Toll-like 2 e 4 (TLR2 e TLR4) associando o processo de sinalização com a presença de agentes infecciosos tais como a Chlamydia pneumoniae (CP) e Mycoplasma pneumoniae (MP), em pacientes com infarto do miocárdio (MI) e em aneurismas aórticos. Foram obtidos fragmentos de aortas ascendentes de pacientes submetidos à cirurgia de revascularização do miocárdio (G1, n=13) e de fragmentos de pacientes submetidos à cirurgia de correção de aneurisma aórtico (G2, n=14). Amostras congeladas e parafinadas foram analisadas por Imunohistoquímica (lHO) e Hibridização in situ (HIS) para detecção e localização da presença dos patógenos e TLRs. Realizou-se uma semiquantificação em microscópio (O, ausente; 1, discreto e focal; 2, moderado e focal e 3, intenso e difuso). Observou-se o grau de inflamação e de acúmulo de gordura. Outrossim, realizou-se PCR em tempo real (SYBR Green) para pesquisa de DNA de CP e MP, como também análise da expressão de mRNA de TLR2 e de TLR4. Na lHQ, constatou-se presença de MP, CP, TLR2 e TLR4 (G1 e G2), maior quantidade de MP (p=0,012) e de TLR4 (p=0,017) no G2. Houve correlação de CP com MP (r=0,810 e p=0,003) e de TLR2 com TLR4 (r=0,569 e p=0,034). Na HIS, constatou-se presença de MP, CP, TLR2 e TLR4 (G1 e G2), não houve diferenças significativas comparando-se os grupos (G1 x G2), porém houve correlação, no G1, de CP com TLR4 (r=0,730 e p=0,040) e de infiltrado inflamatório com células adiposas (r=0,700 e p=0,036). No G2, houve várias correlações: MP com CP (r=0,620 e p=0,016), MP com TLR4 (r=0,662 e p=0,010), CP com TLR2 (r=O,733 e p=0,003), CP com TLR4 (r=0,589 e p=0,027) e de TLR2 com TLR4 (r=0,714 e p=0,004). A PCR em tempo real mostrou presença de CP, pela segunda extração de DNA realizada (G2). Não houve diferença de expressão dos TLRs entre os grupos. A expressão de TLR2 foi maior do que de TLR4 no G1 (p=0,006). O grau de inflamação e o acúmulo de gordura foram maiores no G2 do que no G1(p=0,001). Estes dados sugerem uma relação da co-infecção CP e MP, na gravidade do processo inflamatório presente em placas ateroscleróticas e em pacientes com infarto do miocádio, como também, participação dos receptores Toll-like 2 e 4.
Title in English
Possible involvement of Chlamydia pneumoniae and Mycoplasma pneumoniae in the inflammatory response of atherosclerosis
Keywords in English
Atherosclerosis
Chlamydia pneumoniae
Clinical biochemistry
Immunohistochemistry
Mycoplasma pneumoniae
Real-time PCR
Toll-like Receptors
Abstract in English
The atherosclerosis is a complex and multifactorial process that is not still completely elucidated. It has been proposed that immune-mediate response to inflammatory and/or infectious processes is implicated in the pathogenesis of the atherosclerotic lesions. Toll-like receptors (TLRs) are involved in the innate response and other physiological events through binding to endogenous and exogenous ligands and it may be involved in the atherogenic process To investigate the Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) expression in atheroma plaques and its association with the presence of infectious agents such as Chlamydia pneumoniae (CP) and Mycoplasma pneumoniae (MP) in patients with myocardial infarction (MI) and aortic aneurysms. Fragments of ascending aorta were obtained from MI patients submitted to surgeries of revascularization of the myocardium (G1, n=13) and correction of aortic aneurism (G2, n=14). Frozen and paraffined samples slices were analyzed by Immunohistochemistry (lHQ) and in situ Hybridization for detection and localization of TLR2 and TLR4 expression and CP and MP antigens. There was semiquantification in microscope (0, absent; 1, discreet and focal; 2, moderate and focal; and 3, intense and diffuse). Histopathology was also carried out to investigate the inflammation degree and fat accumulation in these tissues. Real time PCR using SYBR Green System detection was used to stydy DNA CP and MP, also to analyze expression of mRNA TLR2 and TLR4. Using lHQ, it was verified presence of MP, CP, TLR2 and TLR4 (G1 and G2), larger amount of MP (p=0.012) and TLR4 (p=0.017) in G2. In G1 group, MP was positively correlated with CP (r=0.810, p=0.003), in G2, TLR2 with TLR4 (r=0.569, p=0.034). Using HIS, it was verified presence of MP, CP, TLR2 and TLR4 (G1 and G2), there were not significant differences between groups (G1 x G2), however, It was shown correlation between in G1, CP with TLR4 (r=0.730, p=0.040) and also inflammation with fat accumulation (r=0.700, p=0.036). In G2, there were several correlations: presence of MP with CP (r=0.620, p=0.016), MP with TLR4 (r=0.662, p=0.010), CP with TLR2 (r=0.733 p=0,003), CP with TLR4 (r=0.589, p=0.027) and TLR2 with TLR4 (r=0.714, p=0.004). Real time PCR showed presence of CP DNA using second purification accomplished (G2). There was not difference of expression TLRs among the groups. The expression of TLR2 was higher than TLR4 in G1 (p=0.006). Increased degree of inflammation and fat accumulation was also find in G2 than in G1 (p=0.001). These results are suggesting that the gravity of the inflammatory process in atherosclerotic plaques strongly are related to the presence of MP and CP co infection and expression of TLR2 and TLR4, as well in MI patients under myocardial revascularization.
 
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Publishing Date
2017-09-22
 
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