RESUMO
The objective of this study was to demonstrate the presence of mycobacterial nucleic acid sequences in peripheral blood and arteries from patients with Takayasu arteritis (TA). Polymerase chain reaction was performed to detect mycobacterial DNA from three different nucleic acid sequences including the insertion sequence (IS) 6110, the 65-kDa heat shock protein gene (HSP65), and the 16S ribosomal RNA (rRNA) gene in peripheral blood from 32 TA patients and in arterial specimens from 10 TA patients. Twenty-eight HIV-negative patients with pulmonary tuberculosis prior to therapy were tested for IS6110 in peripheral blood as positive controls, and 24 blood donors were evaluated as healthy controls (HC). All TA patients were negative for the insertion sequence IS6110 and for HSP65 and 16S rRNA genes in blood samples and in arterial specimens. IS6110 sequence was found in peripheral blood from 22 (78.5 %) patients with pulmonary tuberculosis but not in HC. In conclusion, the strategy of mycobacterial-specific nucleic acid amplification in the peripheral blood and arterial specimens of TA patients was unable to lend support to the association between TA and tuberculosis long suggested in the literature.
Assuntos
Artérias/microbiologia , DNA Bacteriano/sangue , Arterite de Takayasu/microbiologia , Adolescente , Adulto , Proteínas de Bactérias/genética , Estudos de Casos e Controles , Chaperonina 60/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis , Reação em Cadeia da Polimerase , RNA Ribossômico 16S/genética , Arterite de Takayasu/sangue , Tuberculose Pulmonar/sangue , Tuberculose Pulmonar/epidemiologiaRESUMO
Takayasu's arteritis (TA) is a large vessel vasculitis of unknown aetiology characterised by involvement of the aorta and its major branches. Tuberculous arteritis of the aorta is an uncommon condition usually secondary to the dissemination of Mycobacterium tuberculosis infection from the mediastinum and/or lung to the adjacent aorta; this may mimic TA. We report a case of a 23-year-old woman with cutaneous granulomatous vasculitis and saccular aneurysmal dilation of the aorta and large vessels, and highlight the findings shared by TA and tuberculous arteritis.
Assuntos
Aorta/patologia , Derivação Cardíaca Esquerda , Arterite de Takayasu/diagnóstico , Tuberculose Cardiovascular/diagnóstico , Adulto , Anti-Inflamatórios/administração & dosagem , Antígenos de Bactérias/sangue , Antituberculosos/administração & dosagem , Feminino , Derivação Cardíaca Esquerda/métodos , Humanos , Imunidade Celular , Leucócitos Mononucleares/imunologia , Prednisolona/administração & dosagem , Arterite de Takayasu/complicações , Arterite de Takayasu/microbiologia , Arterite de Takayasu/patologia , Arterite de Takayasu/terapia , Resultado do Tratamento , Tuberculose Cardiovascular/complicações , Tuberculose Cardiovascular/patologia , Tuberculose Cardiovascular/terapiaRESUMO
BACKGROUND: Takayasu's arteritis (TA) is a chronic inflammatory disease affecting the large arteries and their branches; its etiology is still unknown. In individuals suffering from TA, arterial inflammation progresses to stenosis and/or occlusion, leading to organ damage and affecting survival. Relation of TA with Mycobacterium tuberculosis has been known, but there have been only a few systematic studies focusing on this association. The IS6110 sequence identifies the Mycobacterium tuberculosis complex and the HupB establishes the differences between M. tuberculosis and M. bovis. Our objective was to search the presence of IS6110 and HupB genes in aorta of patients with TA. METHODS: We analyzed aorta tissues embedded in paraffin from 5760 autopsies obtained from our institution, we divided the selected samples as cases and controls; CASES: aortic tissues of individuals with Takayasu's arteritis. Control positive: aortic tissues (with tuberculosis disease confirmed) and control negative with other disease aortic (atherosclerosis). RESULTS: Of 181 selected aorta tissues, 119 fulfilled the corresponding criteria for TA, TB or atherosclerosis. Thus 33 corresponded to TA, 33 to tuberculosis (TB) and 53 to atherosclerosis. The mean age was 22 ± 13, 41 ± 19, and 57 ± 10, respectively. IS6110 and HupB sequences were detected in 70% of TA tissues, 82% in tuberculosis, and in 32% with atherosclerosis. Important statistical differences between groups with TA, tuberculosis versus atherosclerosis (p = 0.004 and 0.0001, respectively) were found. CONCLUSION: We identified a higher frequency of IS6110 and HupB genes in aortic tissues of TA patients. This data suggests that arterial damage could occur due to previous infection with M. tuberculosis.