Cytomegalovirus and proliferative signals in the vascular wall of CABG patients

Area of Science:

• Cardiovascular Research
• Infectious Diseases
• Pathology

Background:

• Atherosclerosis is a complex disease influenced by various factors.
• The role of human cytomegalovirus (CMV) in promoting atherosclerosis requires further elucidation.
• Understanding CMV's impact on vascular inflammation is crucial for developing targeted therapies.

Purpose of the Study:

• To investigate the mechanism by which CMV may promote atherosclerosis.
• To examine the expression of inflammatory and proliferative signals in the aortic wall of CMV-positive and CMV-negative patients undergoing coronary artery bypass grafting (CABG).

Main Methods:

• Aortic biopsies and blood samples from 68 CABG patients were analyzed for CMV-DNA using PCR and in situ hybridization.
• Immunohistochemistry was employed to assess the expression of pp65 antigen, adhesion molecules (ICAM-1, VCAM-1, E-selectin), growth factors (PDGF-AA, TGF-beta), and Ki-67.
• Logistic regression analysis correlated CMV presence with vascular inflammation and traditional atherosclerosis risk factors.

Main Results:

• CMV-DNA was detected in the aortic tissue of 76% of patients, primarily within vascular smooth muscle cells.
• CMV-positive patients exhibited increased expression of adhesion molecules and growth factors in the aortic endothelium compared to CMV-negative patients.
• Elevated C-reactive protein (CRP), adhesion molecules, and growth factors correlated positively with CMV presence. Female gender, smoking, and hyperlipidemia were identified as risk factors for CMV positivity.

Conclusions:

• CMV-DNA in smooth muscle cells stimulates local growth factor production and endothelial activation, contributing to atherosclerosis progression.
• Traditional atherogenic risk factors increase the likelihood of aortic CMV manifestation.
• CMV plays a significant role in mediating the progression of atherosclerosis.