Viridans streptococcal immunopositivity associates with calcified coronary plaque area and coronary stenosis severity. The Tampere Sudden Death Study (TSDS)

Abstract

Background and Aims : Development of atherosclerosis shares features of chronic inflammation. Most chronic infections are considered to be due to biofilms. We have shown that coronary atheromas and thrombosis aspirates harbor DNA from several oral bacteria among which DNA from viridans group streptococci was the most common. In the oral cavity viridans streptococci act as early colonizers in the formation of dental biofilm which calcifies into dental plaque. Here we studied whether viridans streptococcal immunopositivity correlates with coronary calcification and stenosis percentage.Methods: The surface areas of atherosclerosis lesion types (fatty, fibrous, calcified, complicated) and stenosis percentage were measured in the left anterior descending (LAD) coronary artery of 121 victims of sudden out-of-hospital death in the Tampere Sudden Death Study (TSDS). Coronary sections were stained immunohistochemically with a pool of antibodies raised against 3 most common viridans streptococcal strains. The strength of the immunopositivity was scored into no positivity (-), slight (+), moderate (++) or severe (+++).Conclusions: Viridans streptococcal immunopositivity of coronary atheromas was linked with coronary atheroma calcification and stenosis but not with other atherosclerosis lesion types. This suggests a new mechanism involved in the calcification of coronary atheroma. Background and Aims : Development of atherosclerosis shares features of chronic inflammation. Most chronic infections are considered to be due to biofilms. We have shown that coronary atheromas and thrombosis aspirates harbor DNA from several oral bacteria among which DNA from viridans group streptococci was the most common. In the oral cavity viridans streptococci act as early colonizers in the formation of dental biofilm which calcifies into dental plaque. Here we studied whether viridans streptococcal immunopositivity correlates with coronary calcification and stenosis percentage. Methods: The surface areas of atherosclerosis lesion types (fatty, fibrous, calcified, complicated) and stenosis percentage were measured in the left anterior descending (LAD) coronary artery of 121 victims of sudden out-of-hospital death in the Tampere Sudden Death Study (TSDS). Coronary sections were stained immunohistochemically with a pool of antibodies raised against 3 most common viridans streptococcal strains. The strength of the immunopositivity was scored into no positivity (-), slight (+), moderate (++) or severe (+++). Conclusions: Viridans streptococcal immunopositivity of coronary atheromas was linked with coronary atheroma calcification and stenosis but not with other atherosclerosis lesion types. This suggests a new mechanism involved in the calcification of coronary atheroma.