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Silvio flu

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SHAPE Society

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Silvio flu

  1. 1. Respiratory Infection of Apo E KO Mice Causes Excessive Plaque Inflammation Implication for triggering effect of flu in human heart attack Adeeba Akhtar MD, Silvio Litovsky, MD, Philip Wyde PhD, Mohammad Madjid MD, Ward Casscells MD, James Willerson MD, Morteza Naghavi MD.
  2. 2. Background • The role of infection in atherosclerosis has been known for years. • A number of pathogens such as C. pneumonia, HSV, CMV have been reported to be present in the plaque and moreover related to CHD • Other chronic infections such as H. pylori, and dental infection were also found to increase likelihood of chronic coronary heart disease.
  3. 3. Background • However, acute effect of infection in triggering coronary events has not received as much attention. • A number of retrospective epidemiological studies have shown the relationship between acute upper respiratory infection and myocardial infarction.
  4. 4. Background • The role of inflammation and inflammatory cytokines in the development of vulnerable plaque and plaque rupture is now well established. • Increased circulating cytokines was shown to accelerate plaque formation in Apo E mice. • Influenza infection can increase thrombogenecity of blood by increasing platelet aggregation. • We have previously shown in a case-control study that flu vaccination is associated with reduced recurrence of MI.
  5. 5. Background Therefore we have hypothesized : • 1) Acute influenza infection of old Apo E deficient mice may cause acute coronary event and heart attack. • 2) Acute influenza infection can increase plaque inflammation and macrophage infiltration, with or without rupture/erosion.
  6. 6. Study Design 42 ApoE Mice Controls infected with Influenza virus Hong Kong P9 LD50 9 Direct infection 24 Intranasal inoculation 9 33 6 sacrificed 3died 11sacrificed 13died
  7. 7. Procedure: • We measured the baseline weight , heart rate, pulse oximetry of all the infected mice and measured these parameters again before sacrificing. • This was a short term (15 days) study and the mice were sacrificed at 3, 5, 10, 15 days. • After sacrifice we took the heart and aorta in formalin and cut 5 sections for each aorta and one mid-transverse ventricular section of the heart.
  8. 8. Examinations • Weight (substitute for Temp) • Oxygen sat. • Pulse • Lung virus titration. • rtPCR for influenza virus. • CBC and Hb. • Blood smear. • Multiple aorta and heart specimens for pathology examinations, H&E, Movat, CD68, TUNEL, actin, CD3 staining.
  9. 9. General Findings • - As expected based on LD 50%, old mice were prompted to die mainly due to overwhelming lung infection . But we sacrificed most of them at their maximum load of infection. • Significant weight loss occurred in all infected mice but not in control mice.
  10. 10. Specific Findings • Hot and ground-breaking !!! …
  11. 11. Control mice 1(power10)
  12. 12. Control mice 1(Power40)
  13. 13. Control mice 2(power 40)
  14. 14. Control mice 3(power 10)
  15. 15. Control mice 3(power40)
  16. 16. Infected Mice 1(Intra nasal group)Power 10
  17. 17. Power 40
  18. 18. Power100
  19. 19. Infected mice2( Intranasal group) power10
  20. 20. Power 40
  21. 21. Power100
  22. 22. Infected mice3(Intranasal group) power4
  23. 23. power10
  24. 24. Power40
  25. 25. power100
  26. 26. Infected mice4(Intranasal Group) Power 10
  27. 27. Power 40
  28. 28. Power100
  29. 29. Infected Mice5 (Intranasal group) power 4
  30. 30. Power10
  31. 31. Power40
  32. 32. Infected Mice6 (Intranasal group)power4
  33. 33. Power10
  34. 34. Power40a
  35. 35. Power40b
  36. 36. Power100
  37. 37. Infected Mice 7( Direct group) Power10
  38. 38. Power40
  39. 39. Infected Mice8 (Intranasal Group) Power 10
  40. 40. power40
  41. 41. Power100
  42. 42. Infected Mice 1(Intranasal Group) Power10
  43. 43. Power40
  44. 44. InfectedMice2(Intranasal Group Power4)
  45. 45. Power10
  46. 46. Power40
  47. 47. Infected mice 6(Intransal Group)Power4
  48. 48. Power 10
  49. 49. Power 40
  50. 50. Actin staining 1power40
  51. 51. Actin staining2 power100
  52. 52. CD3staining Power 40
  53. 53. CD3staining power 100
  54. 54. KP-1 staining (Power 40)
  55. 55. Conclusion: • One third of the infected mice developed this inflammatory infiltrate associated with clusters of platelets and occasionally fibrin overlying the infiltrate. • The infiltrate is polymorphic (macrophages, smooth muscle cells, T-lymphocytes). Next set of stainings will be done on frozen tissue to improve antigenicity. • Upregulation of inflammatory and procoagulant cytokines and receptors will be investigated. • Longer-term studies will investigate the possible
  56. 56. Adeeba ! Mitra ! Mort ! Khawar ! Tania ! Birendra !Mohammad ! Silvio ! Moein ! Sadaf ! Reza !

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