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(Circulation. 2003;107:762.)
© 2003 American Heart Association, Inc.

Basic Science Reports

Influenza Infection Exerts Prominent Inflammatory and Thrombotic Effects on the Atherosclerotic Plaques of Apolipoprotein E–Deficient Mice

Morteza Naghavi, MD; Philip Wyde, PhD; Silvio Litovsky, MD; Mohammad Madjid, MD; Adeeba Akhtar, MD; Sameh Naguib, MD; Mir Said Siadaty, MD; Susan Sanati, MD; Ward Casscells, MD

From the Center for Vulnerable Plaque Research at the University of Texas–Houston Health Science Center, Division of Cardiology, and the Texas Heart Institute, President Bush Center for Cardiovascular Health at Memorial Hermann Hospital (M.N., S.L., M.M., A.A., S.N., M.S.S., S.S., W.C.), and the Department of Molecular Virology and Microbiology, Baylor College of Medicine (P.W.), Houston, Tex.

Correspondence to Morteza Naghavi, MD, Center for Vulnerable Plaque Research at the University of Texas–Houston Division of Cardiology and the Texas Heart Institute, 6431 Fannin, MSB 1.618, Houston, TX 77030. E-mail mnaghavi{at}vp.org

Background— The role of infection in the development and complications of atherosclerosis has been the focus of much attention. We reported previously that influenza vaccination was associated with reduced risk of recurrent myocardial infarction. Here, we report the effect of influenza A virus on the apolipoprotein E–deficient (apoE^-/-) mouse, an animal model of atherosclerosis.

Methods and Results— Twenty-four apoE^-/- mice >24 months old were injected with 1 LD₅₀ (lethal dose 50) of influenza A virus. Ten wild-type C57BL/6 infected mice and 11 noninfected age-matched apoE^-/- mice served as controls. Multiple aortic sections were studied histologically 3, 5, and 10 days later. The infected mice showed markedly increased intimal cellularity compared with the noninfected apoE^-/- mice. No aortic abnormalities were seen in infected wild-type mice. Ten infected apoE^-/- mice had a significant subendothelial infiltrate composed of a heterogeneous group of cells that stained positively for smooth muscle cell actin, F4/80 (macrophages), and CD3 (T lymphocytes). One case of subocclusive platelet and fibrin-rich thrombus was seen.

Conclusions— This study shows that influenza infection promotes inflammation, smooth muscle cell proliferation, and fibrin deposition in atherosclerotic plaques.

Key Words: influenza • atherosclerosis • inflammation • thrombosis • plaque

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