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Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Idiopathic dilated cardiomyopathy (IDCM) myocardial inflammation may be associated with external triggering factors such as infectious agents. Here, we searched if moderate\/severe heart transplantation rejection is related to the presence of myocardial inflammation in IDCM explanted hearts, associated with microbial communities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Receptor myocardial samples from 18 explanted hearts were separated into groups according to post-transplant outcome: persistent moderate rejection (PMR; n = 6), moderate rejection (MR; n = 7) that regressed after pulse therapy, and no rejection (NR; n = 5)\/light intensity rejection. Inflammation was quantified through immunohistochemistry (IHC), and infectious agents were evaluated by IHC, molecular biology, <jats:italic>in situ<\/jats:italic> hybridization technique, and transmission electron microscopy (TEM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>NR presented lower numbers of macrophages, as well as B cells (p = 0.0001), and higher HLA class II expression (p \u2264 0.0001). PMR and MR showed higher levels of <jats:italic>Mycoplasma pneumoniae<\/jats:italic> (p = 0.003) and hepatitis B core (p = 0.0009) antigens. NR presented higher levels of parvovirus B19 (PVB19) and human herpes virus 6 (HHV6) and a positive correlation between <jats:italic>Borrelia burgdorferi<\/jats:italic> (Bb) and enterovirus genes. Molecular biology demonstrated the presence of <jats:italic>M. pneumoniae<\/jats:italic>, Bb, HHV6, and PVB19 genes in all studied groups. TEM\u202frevealed structures compatible with the cited microorganisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This initial study investigating on infectious agents and inflammation in the IDCM explanted hearts showed that the association between <jats:italic>M. pneumoniae<\/jats:italic> and hepatitis B core was associated with a worse outcome after HT, represented by MR and PMR, suggesting that different IDCM microbial communities may be contributing to post-transplant myocardial rejection.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2021.732276","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T13:56:00Z","timestamp":1638366960000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Distinct Microbial Communities in Dilated Cardiomyopathy Explanted Hearts Are Associated With Different Myocardial Rejection Outcomes"],"prefix":"10.3389","volume":"11","author":[{"given":"Jaqueline de Jesus","family":"Pereira","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renata Nishiyama","family":"Ikegami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce Tiyeko","family":"Kawakami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sh\u00e9rrira Menezes","family":"Garavelo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcia Martins","family":"Reis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suely Aparecida Pinheiro","family":"Palomino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandrigo","family":"Mangini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camila Rodrigues","family":"Moreno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samar Freschi de","family":"Barros","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aline Rodrigues","family":"Souza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria de Lourdes","family":"Higuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"E150","DOI":"10.1086\/590958","article-title":"Multiple Infections, Immune Dynamics, and the Evolution of Virulence","volume":"172","author":"Alizon","year":"2008","journal-title":"Am. 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