Recent activation of the plaque immune response in coronary lesions underlying acute coronary syndromes.
OBJECTIVE
To discriminate between chronic inflammation and acute activation of the plaque immune response in culprit lesions of patients with acute coronary syndromes.


METHODS
Retrospective study.


METHODS
Tertiary referral centre.


METHODS
71 patients having coronary atherectomy were classified according to their ischaemic syndrome: stable angina (n = 23); stabilised unstable angina (n = 18); refractory unstable angina (n = 11); and acute myocardial infarction (n = 19).


METHODS
Immunohistochemical measurement of interleukin 2 receptor (IL-2R) (CD25) positive cells expressed as a percentage of the total amount of (CD3 positive) T lymphocytes in frozen sections of atherectomy specimens.


RESULTS
The number of lesions containing IL-2R (CD25) positive T cells increased with severity of the ischaemic coronary syndrome (stable angina, 52%; stabilised unstable angina, 77.8%; refractory unstable angina, 90.9%; acute myocardial infarction, 89.4%). The percentage of activated T cells (CD25/CD3 ratios x100) increased in lesions associated with refractory unstable angina (7.8%) and acute myocardial infarction (18.5%), compared with those in lesions associated with either chronic stable angina (2.2%) or stabilised unstable angina (3.3%).


CONCLUSIONS
An increase in the percentage of IL-2R positive T lymphocytes in culprit lesions of patients with acute coronary syndromes indicates recent activation and amplification of the immune response within plaques. This may result in a burst of inflammatory products with tissue degrading and vasoactive properties and, hence, could initiate or accelerate the onset of an acute coronary event.
van der Wal
A C
AC
Department of Cardiovascular Pathology, University of Amsterdam, Netherlands.
Piek
J J
JJ
de Boer
O J
OJ
Koch
K T
KT
Teeling
P
P
van der Loos
C M
CM
Becker
A E
AE
D000787:Angina Pectoris / Q000276:immunology / Q000601:surgery; D000789:Angina, Unstable / Q000276:immunology / Q000601:surgery; D017225:Atherectomy, Coronary; D017252:CD3 Complex / Q000032:analysis; D003327:Coronary Disease / Q000276:immunology* / Q000601:surgery; D003331:Coronary Vessels / Q000276:immunology*; D006801:Humans; D007150:Immunohistochemistry; D008213:Lymphocyte Activation; D009203:Myocardial Infarction / Q000276:immunology / Q000601:surgery; D015375:Receptors, Interleukin-2 / Q000032:analysis*; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000276:immunology*
D017252:CD3 Complex; D015375:Receptors, Interleukin-2