AI Article Synopsis

  • Cardiac sarcoidosis (CS) is a rare but serious condition that requires early diagnosis, and researchers are investigating the role of Propionibacterium acnes in its development.
  • *The study analyzed myocardial tissues from CS patients and compared them with those from patients with myocarditis and other heart diseases to identify the presence of P. acnes.
  • *Results showed that P. acnes was commonly found in granulomas and inflammatory foci in CS samples, suggesting a potential link between this bacterium and the disease, which could help differentiate CS from other cardiac conditions.

Article Abstract

Background: Although rare, cardiac sarcoidosis (CS) is potentially fatal. Early diagnosis and intervention are essential, but histopathologic diagnosis is limited. We aimed to detect Propionibacterium acnes, a commonly implicated etiologic agent of sarcoidosis, in myocardial tissues obtained from CS patients.

Methods And Results: We examined formalin-fixed paraffin-embedded myocardial tissues obtained by surgery or autopsy and endomyocardial biopsy from patients with CS (n = 26; CS-group), myocarditis (n = 15; M-group), or other cardiomyopathies (n = 39; CM-group) using immunohistochemistry (IHC) with a P. acnes-specific monoclonal antibody. We found granulomas in 16 (62%) CS-group samples. Massive (≥14 inflammatory cells) and minimal (<14 inflammatory cells) inflammatory foci, respectively, were detected in 16 (62%) and 11 (42%) of the CS-group samples, 10 (67%) and 10 (67%) of the M-group samples, and 1 (3%) and 18 (46%) of the CM-group samples. P. acnes-positive reactivity in granulomas, massive inflammatory foci, and minimal inflammatory foci were detected in 10 (63%), 10 (63%), and 8 (73%) of the CS-group samples, respectively, and in none of the M-group and CM-group samples.

Conclusions: Frequent identification of P. acnes in sarcoid granulomas of originally aseptic myocardial tissues suggests that this indigenous bacterium causes granuloma in many CS patients. IHC detection of P. acnes in massive or minimal inflammatory foci of myocardial biopsy samples without granulomas may be useful for differentiating sarcoidosis from myocarditis or other cardiomyopathies.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501515PMC
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0179980PLOS

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