Possible action of immunossupressive therapy on proliferation of antigens and DNA from Borrelia burgerdorferi and Chlamydophila pneumoniae in the myocardium: comparison of their levels before and after heart transplantation, and relationship with rejection

• Grant number: 12/12179-2
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: September 01, 2012
• End date: July 31, 2013
• Field of knowledge: Health Sciences - Medicine - Pathological Anatomy and Clinical Pathology
• Principal Investigator: Maria de Lourdes Higuchi
• Grantee: Rafael Do Rosário Azevedo Ferreira
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Heart Failure (HF) is one of the biggest health problems in the world. In United States, five millions patients are affected, death occurring in 30 to 40% after one year of the diagnosis. The costs related to the disease are approximately 30 billions of dollars; the complexity, morbidity and mortality are similar in Brazil. DNAs from viral agents, Borrelia burgerdorferi and Chlamydophila pneumoniae have been found in large amount of endomyocardial biopsies with lymphocytic myocarditis and Dilated Cardiomyopathy (DCM). However the incidence and quantity of infectious agents in the literature not are uniform, as well as the response of the patients to treatments with the use of antiviral or immunomodulators drugs. The lack of uniform results seems to be linked to different techniques used and not to epidemiologic reasons. On the other hand, the sum of percentages of positivity for different infectious agents reported in the literature exceeds 100%. Co-infection, described in some papers, may explain it. The use of a series of techniques for detection of infectious agents such as, immunohistochemistry, PCR and electron microscopy may provide more reliability in the results that, in association with immune response, clinical data and histology may better guide different treatments, such as antibiotics, immunomodulators, immunosuppressant, or antiviral. (AU)