Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients

Naoya Asakawa, Keisuke Uchida, Mamoru Sakakibara, Kazunori Omote, Keiji Noguchi, Yusuke Tokuda, Kiwamu Kamiya, Kanako C. Hatanaka, Yoshihiro Matsuno, Shiro Yamada, Kyoko Asakawa, Yuichiro Fukasawa, Toshiyuki Nagai, Toshihisa Anzai, Yoshihiko Ikeda, Hatsue Ishibashi-Ueda, Masanori Hirota, Makoto Orii, Takashi Akasaka, Kenta Uto & 5 others Yasushige Shingu, Yoshiro Matsui, Shin ichiro Morimoto, Hiroyuki Tsutsui, Yoshinobu Eishi

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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.

Original languageEnglish
Article numbere0179980
JournalPloS one
Volume12
Issue number7
DOIs
Publication statusPublished - Jul 1 2017

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Propionibacterium acnes
granuloma
Sarcoidosis
Granuloma
Biopsy
Tissue
myocarditis
cells
cardiomyopathy
sampling
Paraffin
Surgery
Formaldehyde
Bacteria
immunohistochemistry
Monoclonal Antibodies
biopsy
Myocarditis
sarcoid
Cardiomyopathies

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients. / Asakawa, Naoya; Uchida, Keisuke; Sakakibara, Mamoru; Omote, Kazunori; Noguchi, Keiji; Tokuda, Yusuke; Kamiya, Kiwamu; Hatanaka, Kanako C.; Matsuno, Yoshihiro; Yamada, Shiro; Asakawa, Kyoko; Fukasawa, Yuichiro; Nagai, Toshiyuki; Anzai, Toshihisa; Ikeda, Yoshihiko; Ishibashi-Ueda, Hatsue; Hirota, Masanori; Orii, Makoto; Akasaka, Takashi; Uto, Kenta; Shingu, Yasushige; Matsui, Yoshiro; Morimoto, Shin ichiro; Tsutsui, Hiroyuki; Eishi, Yoshinobu.

In: PloS one, Vol. 12, No. 7, e0179980, 01.07.2017.

Research output: Contribution to journalArticle

Asakawa, N, Uchida, K, Sakakibara, M, Omote, K, Noguchi, K, Tokuda, Y, Kamiya, K, Hatanaka, KC, Matsuno, Y, Yamada, S, Asakawa, K, Fukasawa, Y, Nagai, T, Anzai, T, Ikeda, Y, Ishibashi-Ueda, H, Hirota, M, Orii, M, Akasaka, T, Uto, K, Shingu, Y, Matsui, Y, Morimoto, SI, Tsutsui, H & Eishi, Y 2017, 'Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients', PloS one, vol. 12, no. 7, e0179980. https://doi.org/10.1371/journal.pone.0179980
Asakawa, Naoya ; Uchida, Keisuke ; Sakakibara, Mamoru ; Omote, Kazunori ; Noguchi, Keiji ; Tokuda, Yusuke ; Kamiya, Kiwamu ; Hatanaka, Kanako C. ; Matsuno, Yoshihiro ; Yamada, Shiro ; Asakawa, Kyoko ; Fukasawa, Yuichiro ; Nagai, Toshiyuki ; Anzai, Toshihisa ; Ikeda, Yoshihiko ; Ishibashi-Ueda, Hatsue ; Hirota, Masanori ; Orii, Makoto ; Akasaka, Takashi ; Uto, Kenta ; Shingu, Yasushige ; Matsui, Yoshiro ; Morimoto, Shin ichiro ; Tsutsui, Hiroyuki ; Eishi, Yoshinobu. / Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients. In: PloS one. 2017 ; Vol. 12, No. 7.
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title = "Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients",
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.",
author = "Naoya Asakawa and Keisuke Uchida and Mamoru Sakakibara and Kazunori Omote and Keiji Noguchi and Yusuke Tokuda and Kiwamu Kamiya and Hatanaka, {Kanako C.} and Yoshihiro Matsuno and Shiro Yamada and Kyoko Asakawa and Yuichiro Fukasawa and Toshiyuki Nagai and Toshihisa Anzai and Yoshihiko Ikeda and Hatsue Ishibashi-Ueda and Masanori Hirota and Makoto Orii and Takashi Akasaka and Kenta Uto and Yasushige Shingu and Yoshiro Matsui and Morimoto, {Shin ichiro} and Hiroyuki Tsutsui and Yoshinobu Eishi",
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T1 - Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients

AU - Asakawa, Naoya

AU - Uchida, Keisuke

AU - Sakakibara, Mamoru

AU - Omote, Kazunori

AU - Noguchi, Keiji

AU - Tokuda, Yusuke

AU - Kamiya, Kiwamu

AU - Hatanaka, Kanako C.

AU - Matsuno, Yoshihiro

AU - Yamada, Shiro

AU - Asakawa, Kyoko

AU - Fukasawa, Yuichiro

AU - Nagai, Toshiyuki

AU - Anzai, Toshihisa

AU - Ikeda, Yoshihiko

AU - Ishibashi-Ueda, Hatsue

AU - Hirota, Masanori

AU - Orii, Makoto

AU - Akasaka, Takashi

AU - Uto, Kenta

AU - Shingu, Yasushige

AU - Matsui, Yoshiro

AU - Morimoto, Shin ichiro

AU - Tsutsui, Hiroyuki

AU - Eishi, Yoshinobu

PY - 2017/7/1

Y1 - 2017/7/1

N2 - 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.

AB - 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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U2 - 10.1371/journal.pone.0179980

DO - 10.1371/journal.pone.0179980

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