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(Stroke. 2005;36:1896.)
© 2005 American Heart Association, Inc.

Original Contributions

Heme Oxygenase-1 Is Expressed in Carotid Atherosclerotic Plaques Infected by Helicobacter pylori and Is More Prevalent in Asymptomatic Subjects

Sebastian F. Ameriso, MD; Agustina Ruiz Villamil, MD; Christine Zedda, BS; Juan C. Parodi, MD; Sergio Garrido, MD; María Inés Sarchi, PhD; Marcelo Schultz, HT; Jorge Boczkowski, MD, PhD Gustavo E. Sevlever, MD, PhD

From the Institute for Neurological Research (S.F.A., A.R.V., J.C.P., M.S., G.E.S.), FLENI, Buenos Aires, Argentina; Institut National de la Santé et la Recherche Médicale (C.Z., J.B.), INSERM, Paris, France; and the School of Pharmacy and Biochemistry (M.I.S.) and General San Martín Hospital (S.G.), University of Buenos Aires, Argentina.

Correspondence to Sebastián F. Ameriso, MD, Institute for Neurological Research, FLENI, Montañeses 2325, (1428), Buenos Aires, Argentina. E-mail sameriso{at}fleni.org.ar

Background and Purpose— It is not well established what are the features, if any, that distinguish symptomatic from asymptomatic carotid atherosclerotic plaques. Inducible heme oxygenase-1 (HO-1) is a component of cellular defense mechanisms against oxidative stress. We aimed to assess the presence of Helicobacter pylori (H pylori) and the expression of HO-1 in carotid atherosclerotic plaques of patients with and without prior neurologic symptoms attributable to the operated artery.

Methods— We examined 25 symptomatic and 23 asymptomatic carotid atherosclerotic plaques removed during endarterectomy and 7 normal carotid arteries obtained at autopsy. We investigated the presence of H pylori DNA in the vessel wall and performed immunohistochemical detection of HO-1.

Results— H pylori DNA was present in 28 plaques and HO-1 was expressed in 30 plaques. HO-1 was found in 27 H pylori-positive specimens but in only 3 H pylori-negative specimens (P<0.001). All 7 normal carotid arteries were negative for both H pylori and HO-1. Although 82% of asymptomatic specimens were positive for H pylori and 87% for HO-1, only 36% of symptomatic specimens were positive for both H pylori and HO-1 (P<0.01).

Conclusions— This study suggests a strong association between H pylori infection and expression of HO-1 in carotid atherosclerotic plaques. There was a substantial prevalence of these features in specimens obtained from asymptomatic subjects.

Key Words: atherosclerosis • carotid arteries • infection • inflammation • stroke

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Editorial Comment—Is Heme Oxygenase-1 a Causal Player for Plaque Stability?

Christine Espinola-Klein, Stefan Blankenberg, and Thomas Münzel
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