Mehmet KAPLAN, Hakan GERÇEKOĞLU, Fikri YAPICI, Bayer ÇINAR, Şimşek Serap YAVUZ, Mustafa Sinan KUT, Mahmut Murat DEMİRTAŞ, Vedat KÖKSAL

Karotis arter aterom plaklarında Chlamydia pneumoniae ve Helicobacter pylori DNA'sının polimeraz zincir reaksiyonu ile saptanması

Amaç: Aterosklerozun patogenezi multifaktöriyeldir ve hala tartışmalıdır. Konvansiyonel risk faktörleri, ateroskleroz patogenezini tam olarak açıklayamamaktadır. Uzun süredir ateroskleroz patogenezinde bazı mikroorganizmaların, özellikle Chlamydia pneumoniae ve Helicobacter pylori'nin olası rolü ileri sürülmektedir, ancak konu hala çözümlenmiş değildir. Bu çalışmada, karotis arter aterom plaklarında C. pneumoniae ve H. pylori DNA'sının varlığı (polimeraz zincir reaksiyonu) yöntemi ile araştırılmıştır. Materyal ve Metod: Bu prospektif çalışmaya cerrahi girişim için merkezimize başvuran değişik tipte aterosklerotik hastalığı olan 104 ardışık hasta dahil edildi. Karotis endarterektomi yapılan hastaların karotis arterlerinden elde edilen 52 aterosklerotik plak örneği çalışma grubunu, koroner arter bypass greft operasyonu geçiren hastaların asandan aortalarının makroskobik olarak sağlıklı bölgeleri kontrol grubunu oluşturdu. Endarterektomi örneklerinde C. pneumoniae ve H. pylori DNA'larının varlığı araştırıldı. Bulgular: C. pneumoniae DNA'sı, 52 aterom plağının 16'sında (%30.77), 52 makroskobik olarak sağlıklı asandan aort duvar örneklerinin ise 1'nde (%1.92) saptandı (p < 0.001). H. pylori DNA'sı ise, 52 aterom plağının 9'unda (%17.31) saptanırken kontrol grubunda görülmedi (p = 0.003). Elli iki plağın 25'inde (%48) ya C. pneumoniae ya da H. pylori DNA'sı saptandı. Sonuç: Sağlıklı vaskuler duvar örnekleri ile karşılaştırıldığında, aterosklerotik plaklarda C. pneumoniae ve H. pylori DNA'sının yüksek insidansı, bu mikroorganizmaların aterogenez patogenezinde rol oynayabileceğini düşündürmektedir.

Detection of Chlamydia pneumoniae and Helicobacter pylori DNA in atherosclerotic plaques of carotid artery by polimerase chain reaction

Background: Conventional risk factors cannot completely explain the pathogenesis of atherosclerosis. A possible role of some microorganisms, particularly Chlamydia pneumoniae and Helicobacter pylori has been proposed in the pathogenesis of atherosclerosis for a long time, but it is still an unresolved issue. We explored the presence of Chlamydia pneumoniae and Helicobacter pylori DNA in carotid artery atherosclerotic plaques by using "polymerase chain reaction". Methods: Onehundredfour consecutive patients with various types of atherosclerotic diseases who admitted to our center for surgical intervention were included in this prospective study. Fifty-two atherosclerotic plaque specimens that were obtained from carotid arteries of the cases who had carotid endarterectomy constituted the study group and 52 specimens obtained from the macroscopically healthy regions of ascending aorta in cases who undergone coronary artery bypass grafting were the control group. Results: Chlamydia pneumoniae DNA was detected in 16 (30.77%) of 52 atherosclerotic plaques and 1 1.92%) of 52 macroscopically healthy ascending aorta wall specimens (p < 0.001). Helicobacter pylori DNA was detected in 9 (17.31%) of 52 atherosclerotic plaques and none of the controls (p = 0.003). Twenty-five of 52 plaques (48%) were positive either for Chlamydia pneumoniae or Helicobacter pylori. Conclusion: Higher incidence of Chlamydia pneumoniae and Helicobacter pylori DNA in atherosclerotic plaques, compared to healthy vascular walls suggests that these microorganisms may play a role in the pathogenesis of atherogenesis.

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