Evidence map›Paper›PMID 40767295›Full record

ArticleJournal of the American Heart Association2025

Viridans Streptococcal Biofilm Evades Immune Detection and Contributes to Inflammation and Rupture of Atherosclerotic Plaques.

Pekka J Karhunen, Tanja Pessi, Sohvi Hörkkö, Vesa Karhunen, Sirkka Goebeler, Anne-Mari Louhelainen, Mika Martiskainen, Teppo Haapaniemi, Johanna Lappeteläinen, Tommi Ijäs and 10 more

Abstract read
In one paragraph

Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Inflammation and Immune Mechanisms in Atherosclerosis.Reviews in cardiovascular medicine · 2026
    Review
  3. Review
  4. Unmasking the Hidden Burden: Inflammation and Cardiovascular DiseaseJournal of the American Heart Association · 2026
    Article
  5. Third Year in Review, Fourth Year in Preview, and the 2025Journal of the American Heart Association · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Pekka J KarhunenFaculty of Medicine and Health Technology Tampere University, Fimlab Laboratories Ltd., Wellbeing Services County of Pirkanmaa and Finnish Cardiovascular Research Centre Tampere Tampere Finland.ORCID 0000-0002-0320-571X
Tanja PessiFaculty of Medicine and Health Technology Tampere University, Fimlab Laboratories Ltd., Wellbeing Services County of Pirkanmaa and Finnish Cardiovascular Research Centre Tampere Tampere Finland.
Sohvi HörkköMedical Microbiology and Immunology, Research Unit of Biomedicine and Internal Medicine University of Oulu Finland.ORCID 0000-0003-2118-5270
Vesa KarhunenFaculty of Medicine and Health Technology Tampere University, Fimlab Laboratories Ltd., Wellbeing Services County of Pirkanmaa and Finnish Cardiovascular Research Centre Tampere Tampere Finland.
Sirkka GoebelerFaculty of Medicine and Health Technology Tampere University, Fimlab Laboratories Ltd., Wellbeing Services County of Pirkanmaa and Finnish Cardiovascular Research Centre Tampere Tampere Finland.ORCID 0000-0002-8968-8328
Anne-Mari LouhelainenFaculty of Medicine and Health Technology Tampere University, Fimlab Laboratories Ltd., Wellbeing Services County of Pirkanmaa and Finnish Cardiovascular Research Centre Tampere Tampere Finland.ORCID 0000-0002-9696-3877
Mika MartiskainenFaculty of Medicine and Health Technology Tampere University, Fimlab Laboratories Ltd., Wellbeing Services County of Pirkanmaa and Finnish Cardiovascular Research Centre Tampere Tampere Finland.
Teppo HaapaniemiFaculty of Medicine and Health Technology Tampere University, Fimlab Laboratories Ltd., Wellbeing Services County of Pirkanmaa and Finnish Cardiovascular Research Centre Tampere Tampere Finland.
Johanna LappeteläinenBioSiteHisto Ltd Tampere Finland.
Tommi IjäsBioSiteHisto Ltd Tampere Finland.
Leo-Pekka LyytikäinenFaculty of Medicine and Health Technology Tampere University, Fimlab Laboratories Ltd., Wellbeing Services County of Pirkanmaa and Finnish Cardiovascular Research Centre Tampere Tampere Finland.
Emma RaitoharjuFaculty of Medicine and Health Technology Tampere University, Fimlab Laboratories Ltd., Wellbeing Services County of Pirkanmaa and Finnish Cardiovascular Research Centre Tampere Tampere Finland.ORCID 0000-0002-7023-8706
Thanos SiorisHeart Hospital Tampere University Hospital Tampere Finland.
Sari TuomistoFaculty of Medicine and Health Technology Tampere University, Fimlab Laboratories Ltd., Wellbeing Services County of Pirkanmaa and Finnish Cardiovascular Research Centre Tampere Tampere Finland.ORCID 0000-0002-2376-6338
Heini HuhtalaFaculty of Social Sciences Tampere University Tampere Finland.ORCID 0000-0003-1372-430X
Chunguang WangMedical Microbiology and Immunology, Research Unit of Biomedicine and Internal Medicine University of Oulu Finland.ORCID 0000-0001-5569-321X
Claudia MonacoKennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford United Kingdom.ORCID 0000-0003-1985-4914
Niku OksalaFaculty of Medicine and Health Technology Tampere University, Fimlab Laboratories Ltd., Wellbeing Services County of Pirkanmaa and Finnish Cardiovascular Research Centre Tampere Tampere Finland.ORCID 0000-0001-5336-3719
Terho LehtimäkiFaculty of Medicine and Health Technology Tampere University, Fimlab Laboratories Ltd., Wellbeing Services County of Pirkanmaa and Finnish Cardiovascular Research Centre Tampere Tampere Finland.ORCID 0000-0002-2555-4427
Reijo LaaksonenFaculty of Medicine and Health Technology Tampere University, Fimlab Laboratories Ltd., Wellbeing Services County of Pirkanmaa and Finnish Cardiovascular Research Centre Tampere Tampere Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBacterial DNA from the oral cavity, respiratory tract, gut, and skin has been detected in atherosclerotic plaques, suggesting a role in chronic inflammation linked to atherosclerosis. Chronic bacterial infections often form biofilms resistant to antibiotics and immune detection, giving rise to a new generation of virulent bacteria in suitable conditions. This study explores the role of the immune system in bacterial-induced inflammation of atherosclerotic plaques.

methodsCoronary plaques from 121 sudden death victims and endarterectomy samples from 96 surgical patients were analyzed using bacterial real-time quantitative polymerase chain reaction, immunohistochemistry, and genome-wide expression analysis. TLR (toll-like receptor) signaling was examined in bacterial-activated TLR cell lines.

resultsOf the bacteria detected, oral viridans group streptococcal DNA was the most common, being found in 42.1% of coronary plaques and 42.9% of endarterectomies. Immunopositivity for viridans streptococci correlated with severe atherosclerosis (

conclusionsLatent chronic bacterial inflammation evades immune detection and may contribute to the pathogenesis of complicated atherosclerotic plaques and fatal myocardial infarction.

Indexed as

BiofilmsCoronary Artery DiseaseCoronary VesselsInflammationPlaque, AtheroscleroticStreptococcal InfectionsAgedDNA, BacterialFemaleHumansImmunity, InnateImmunohistochemistryMacrophagesMaleMiddle AgedRupture, SpontaneousDNA, BacterialToll-Like Receptorsbacteriabiofilmcoronary heart diseaseimmune systemmyocardial infarction

Identifiers

PMID40767295
PMCPMC12533616

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.