Pathological Study on Atherosclerosis Experimentally Induced by Enterococcus faecalis in Rat
DOI:
https://doi.org/10.22317/imj.v9i1.1305Keywords:
Enterococcus faecalis, Oxidative Stress, Vegetative Endocarditis, AtherosclerosisAbstract
Objectives
This study aimed to investigate the potential role of Enterococcus faecalis in the development of atherosclerosis, focusing on two primary mechanisms: the induction of vegetative endocarditis and the promotion of oxidative stress. By examining systemic effects following dissemination of E. faecalis, commonly associated with dental infections, the study sought to explore its possible contribution to cardiovascular pathology.
Methods
E. faecalis was isolated from dental caries lesions and identified as gram-positive cocci using selective and differential culture media. Twenty adult albino rats were randomly divided into two groups (n=10 per group). Group 1 served as the control, while Group 2 received an intraperitoneal injection of E. faecalis suspension (1 mL, 7.8 × 10⁷ CFU/mL). After 90 days, oxidative stress biomarkers—GSH, SOD, TAC, MDA, NO, IL-6, and TNF-α—were measured in cardiac and aortic tissues. Serum CRP levels were assessed to evaluate systemic inflammation. Histopathological examinations of the aorta and heart were conducted to assess structural and inflammatory changes.
Results
Infected rats exhibited significant histopathological alterations in the aorta, including lipid vacuole accumulation, foam cell infiltration in intima and media layers, and fragmentation of elastic fibers. Cardiac examination revealed vegetative endocarditis with bacterial colonies, mononuclear cell infiltration, myocardial fatty degeneration, and mural valve thrombi. Coronary arteries displayed wall thickening, thrombus formation, and periarteritis. Biochemical assays showed elevated oxidative stress markers and significantly increased CRP levels in Group 2 compared to controls.
Conclusion
The findings suggest that systemic E. faecalis infection can contribute to atherosclerosis by promoting both vegetative endocarditis and oxidative stress. This supports a mechanistic link between oral bacterial infections and cardiovascular disease, underscoring the importance of oral health in systemic disease prevention.
References
Fan J, Watanabe T. Atherosclerosis: known and unknown. Pathol Int. 2022;72:151–60. https://doi.org/10.1111/pin.13202
Björkegren JLM, Lusis AJ. Atherosclerosis: recent developments. Cell. 2022;185(10):1630–45. https://doi.org/10.1016/j.cell.2022.04.004
Gisterå A, Ketelhuth DF, Malin SG, Hansson GK. Animal models of atherosclerosis–supportive notes and tricks of the trade. Circ Res. 2022;130(12):1869–87.
Wallig MA, Usborne A, Keenan KP. Nutritional toxicologic pathology. In: Haschek WM, Rousseaux CG, editors. Handbook of Toxicologic Pathology. Vol. 3. Academic Press; 2023. p. 105–80.
Saeed M, Al-Kennany E. Atherosclerosis induced by Enterococcus faecalis in Japanese quails (Coturnix coturnix). 2018.
Mooney CT. Canine hypothyroidism. In: Peterson ME, Kintzer PP, editors. BSAVA Manual of Canine and Feline Endocrinology. BSAVA Library; 2023. p. 128–50.
Ciarambino T, Crispino P, Minervini G, Giordano M. Role of Helicobacter pylori infection in pathogenesis, evolution, and complication of atherosclerotic plaque. Biomedicines. 2024;12(2):400.
Al-Hamdany MG, Al-Kennany E. The pathology of aorta of quails experimentally infected with Enterococcus faecalis. Iraqi J Vet Sci. 2014;28:5–10. https://doi.org/10.33899/ijvs.2014.89464
Al-Kennany E. Capability of Toxoplasma gondii to induce oxidative stress and initiation of atherosclerotic lesions in cats experimentally infected. Iraqi J Vet Sci. 2006;20:165–76. https://doi.org/10.33899/ijvs.2006.62483
Chan NC, Lawson JS, Hirsh J. Human papilloma virus and atherosclerotic cardiovascular disease. Eur Heart J. 2024;45(12):1083–5.
Huycke MM, Moore D, Joyce W, Wise P, Shepard L, Kotake Y, et al. Extracellular superoxide production by Enterococcus faecalis requires demethylmenaquinone and is attenuated by functional terminal quinol oxidases. Mol Microbiol. 2001;42(3):729–40.
Marima R, Basera A, Dumakude PT, Fadebi O, Gabada L, Nyalambisa A, et al. Gut microbiome biomarkers for colorectal cancer diagnosis and prognosis. In: Exploring the Gut Microbiome in Cancer. CRC Press; 2024. p. 82–92.
AL-Khafaji JK. Preparation of modified selective medium for isolation of Enterococcus faecalis in pure culture from heavy sources (rapid diagnosis). Med J Babylon. 2021;18(4):340–2.
Meyer RE. Euthanasia and humane killing. In: Grimm KA, Lamont LA, Tranquilli WJ, Greene SA, Robertson SA, editors. Veterinary Anesthesia and Analgesia: The Sixth Edition of Lumb and Jones. 2024. p. 152–66.
Batty M, Bennett MR, Yu E. The role of oxidative stress in atherosclerosis. Cells. 2022;11(23):3843.
Gaeta C, Marruganti C, Ali IA, Fabbro A, Pinzauti D, Santoro F, et al. The presence of Enterococcus faecalis in saliva as a risk factor for endodontic infection. Front Cell Infect Microbiol. 2023;13:1061645.
Reisinger M, Kachel M, George I. Emerging and re-emerging pathogens in valvular infective endocarditis: a review. Pathogens. 2024;13(7):543.
Tille P. Bailey & Scott's Diagnostic Microbiology. 15th ed. Elsevier Health Sciences; 2022.
Correia AS, Cardoso A, Vale N. Oxidative stress in depression: the link with the stress response, neuroinflammation, serotonin, neurogenesis and synaptic plasticity. Antioxidants. 2023;12(2):470.
Yan R, Zhang X, Xu W, Li J, Sun Y, Cui S, et al. ROS-induced endothelial dysfunction in the pathogenesis of atherosclerosis. Aging Dis. 2024;16:1–9.
Krishnamurthy HK, Pereira M, Rajavelu I, Jayaraman V, Krishna K, Wang T, et al. Oxidative stress: fundamentals and advances in quantification techniques. Front Chem. 2024;12:1470458.
Kavyani Z, Najafi K, Naghsh N, Karvane HB, Musazadeh V. The effects of curcumin supplementation on biomarkers of inflammation, oxidative stress, and endothelial function: a meta-analysis of meta-analyses. Prostaglandins Other Lipid Mediat. 2024;174:106867.
Laib I, Ali BD, Alsalme A, Croun D, Bechelany M, Barhoum A. Therapeutic potential of silver nanoparticles from Helianthemum lippii extract for mitigating cadmium-induced hepatotoxicity. Front Bioeng Biotechnol. 2024;12:1400542.
Nemmar A, Al-Salam S, Beegam S, Yuvaraju P, Ali BH. Aortic oxidative stress, inflammation and DNA damage following pulmonary exposure to cerium oxide nanoparticles in a rat model of vascular injury. Biomolecules. 2019;9(8):376.
Shu L, Yuan Z, Li F, Cai Z. Oxidative stress and valvular endothelial cells in aortic valve calcification. Biomed Pharmacother. 2023;163:114775.
Milojevic Samanovic A, Jakovljevic V, Vasovic M, Mitrovic S, Rankovic M, Mihajlovic K, et al. Cardiac, biochemical and histopathological analysis reveals impaired heart function in hypertensive rats with apical periodontitis. Int Endod J. 2021;54(9):1581–96.
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Iraq Medical Journal

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.