Key result
Severe CAVD valves harbor tissue-associated microbiota and infiltrating T lymphocytes that vary significantly by country.
Why the study?
Growing evidence suggests an active role of the immune system in calcific aortic valve disease (CAVD) that could be modulated by the microbiota, prompting investigation of a valve microbiota and associated immune response.
Observational (n=20)
Yes
The identification of a tissue-associated microbiota and infiltrating T cells in calcified aortic valves suggests a potential role for a local microbiota-immunity axis in the pathogenesis of calcific aortic valve disease.
Suggests microbiota-immunity axis in CAVD pathogenesis; hypothesis-generating and should not yet change practice.
Introduction: Calcific aortic valve disease (CAVD) is the most common heart valve disorder, defined by a remodeling multistep process: namely, valve fibrosis with its area narrowing, impaired blood flow, and final calcification phase. Nowadays, the only treatment is the surgical valve replacement. As for other cardiovascular diseases, growing evidence suggest an active role of the immune system in the calcification process that could be modulated by the microbiota. To address this point, we aimed to investigate and characterize, for the first time, the presence of a valve microbiota and associated immune response in human CAVD. Method: Calcified aortic valve (CAV) samples from twenty patients (11 from Germany and 9 from Italy) with diagnosis of severe symptomatic CAVD were used to assess the presence of infiltrating T cells, by cloning approach, and to characterize the valve microbiota, by 16S rRNA gene sequencing (NGS). Results: We documented the presence of infiltrating T lymphocytes, especially the T helper subset, in CAV samples. Moreover, we found a tissue-associated microbiota in freshly collected CAV samples, which was significantly different in Italian and German patients, suggesting potential correlation with other cardiovascular risk factors. Conclusion: The presence of microbiota in inflamed CAV samples represents the right trigger point to explain the valve calcification process, encouraging further studies to explore the potential link between bacteria and adaptive immune response and to define the critical role of local microbiota-immunity axis on CAVD development.
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Curini et al. (2023) conducted an observational in Calcific aortic valve disease (CAVD) (n=20). Tissue-associated microbiota and infiltrating T lymphocytes were identified in calcified aortic valve samples from 20 patients with severe symptomatic CAVD, differing significantly by country.
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