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Increased incidence of cytomegalovirus but not Chlamydia pneumoniae in atherosclerotic lesions of arteries of lower extremities from patients with diabetes mellitus undergoing amputation

¹ Department of Medical Technology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
² Department of Pathology, Kaohsiung Medical Center, Chang Gung University and Memorial Hospital, Niao-Sung Hsiang, Kaohsiung, Taiwan
³ Department of Internal Medicine, Kaohsiung Medical Center

Correspondence to:
Dr H-L Eng, Department of Pathology, Chang Gung Memorial Hospital, 123, Ta-pei Road, Niao-Sung Hsiang, Kaohsiung, Taiwan;
eng6166{at}ms8.hinet.net

Aims: To evaluate the association between cytomegalovirus (CMV) or Chlamydia pneumoniae infection and the development of accelerated atherosclerotic lesions in patients with diabetes who are known to have an impaired immune response to infection and a high incidence of atherosclerosis.

Methods: Two hundred arterial samples from patients with diabetes who had undergone surgical amputation for gangrenous lower limbs were selected to assess the presence of CMV or C pneumoniae nucleic acid by means of the polymerase chain reaction.

Results: CMV nucleic acid sequences were detected in 64 of 200 (32%) samples and C pneumoniae in seven of 200 (3.5%) arterial samples with severe atherosclerosis. Of those positive for C pneumoniae, six were also positive for CMV.

Conclusion: The significantly higher incidence of CMV nucleic acid sequences in the arterial samples of patients with diabetes supports the hypothesis that this organism is involved in the pathogenesis of atherosclerosis in patients with diabetic mellitus. It is possible that the potential role of different infectious agents in the pathogenesis of atherosclerosis might rely on their biological properties and their infectivity in hosts with varying immunological status.

Keywords: diabetes mellitus; atherosclerosis; cytomegalovirus; Chlamydia pneumoniae

Abbreviations: CMV, cytomegalovirus; IE, immediate early gene; PCR, polymerase chain reaction