| Summary: | Acute myocardial infarction (AMI) is related to rupture of atheroma plaques containing pro-inflammatory cytokines, oxidized low-density lipoprotein (oxLDL) and MMP9, a microenvironment compatible with the presence of a pathogenic microbial community. Recently, infectious extracellular vesicles (iEVs) were discovered to be released in co-infections. Previously, we found iEVs positive for archaea DNA and Mycoplasma pneumoniae (Mp) antigens in vulnerable plaques. Now, looking for serum particles biomarkers to differentiate atherosclerotic clinical outcomes we studied 168 patients (pts) from groups: Atherosclerotic (ATR), AMI, AMI with major severity (sAMI) and healthy (CTL) Methods: We quantified and characterized serum iEVs ( 0.79-1.34 μm) through their content using the Flow Cytometry technique and for cytokines using CBA kit, for exosomes (<100nm) we used Nanosight equipment and for correlations we used Spearman 's test. Results: sAMI pts sera presented increased no. of iEVs positive for archaea DNA and Mp, MMP9, IL6 and IL10 cytokine antigens. TNFα was increased in CTL and ATR compared to both AMI groups. TNFα correlated with archaeal IEVs in sIAM group. There was a significant positive correlation between Mp and MMP9 in the AMI, CTL and ATR groups. A significant positive correlation was present between Mp and IL6 in AMI and sAMI groups. ATR and CTL groups had higher no. of exosomes than the sAMI group. Conclusion: Increased numbers of serum IEVs positive for archaea, Mp and MMP9 elements in association with increased levels of IL6, decreased numbers of protective exosomes and correlation between TNF-α vs archaea, are present in sAMI clinical outcome, which suggests that serum IEVs and cytokines levels may constitute new biomarkers to differentiate atherosclerotic clinical outcomes.
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