title: Immune system activation follows inflammation in unstable angina: pathogenetic implications.
abstract: OBJECTIVE
  The aim of this study was to assess the relations between inflammation, specific immune response and clinical course in unstable angina (UA).
  
  
  BACKGROUND
  Several studies suggest that either inflammation and/or T-cell activation might have a pathogenetic role in UA, but neither their potential reciprocal connection nor their relation to the clinical course is known.
  
  
  METHODS
  Serum levels of C-reactive protein (CRP) (inflammation), IgG, IgA, IgM, C3, C4 (humoral immunity), IL-2 and the percentage of CD4+, CD8+ and CD3+/DR+ T-cells (cell-mediated immunity) were measured in 35 patients with UA and 35 patients with chronic stable angina (CSA) during a period of 6 months.
  
  
  RESULTS
  The CRP levels and the main specific immune markers (CD4+ and CD3+/DR+ cells, IL-2 and IgM) were higher in unstable than in stable angina. In UA, the serum levels of IgM and IL-2 and the percentage of double positive CD3+/DR+ significantly increased at 7 to 15 days, and returned to baseline at 6 months. The increment of circulating activated T cells (CD3+/ DR+) in UA was inversely related to the admission levels of CRP (r=-0.63, p=0.003) and associated with a better outcome.
  
  
  CONCLUSIONS
  Our data suggest that the inflammatory component systemically detectable in UA may be antigen-related and that the magnitude of the immune response correlates with the clinical outcome of instability.
authors.affiliation: Department of Cardiology, Catholic University, Rome, Italy. giuseppina.caligiuri@cmm.ki.se
authors.forename: G
authors.initials: G
authors.lastname: Caligiuri
authors.forename: G
authors.initials: G
authors.lastname: Liuzzo
authors.forename: L M
authors.initials: LM
authors.lastname: Biasucci
authors.forename: A
authors.initials: A
authors.lastname: Maseri
mesh_terms: D000789:Angina, Unstable / Q000097:blood / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D017252:CD3 Complex / Q000276:immunology; D015704:CD4 Antigens / Q000276:immunology; D002908:Chronic Disease; D003176:Complement C3 / Q000378:metabolism; D003181:Complement C4 / Q000378:metabolism; D004562:Electrocardiography; D005500:Follow-Up Studies; D006684:HLA-DR Antigens / Q000276:immunology; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis; D007249:Inflammation / Q000097:blood / Q000276:immunology; D007376:Interleukin-2 / Q000097:blood; D008213:Lymphocyte Activation / Q000276:immunology*; D018655:Lymphocyte Count; D013601:T-Lymphocytes / Q000276:immunology*
chemical_list: D015415:Biomarkers; D017252:CD3 Complex; D015704:CD4 Antigens; D003176:Complement C3; D003181:Complement C4; D006684:HLA-DR Antigens; D007136:Immunoglobulins; D007376:Interleukin-2; D002097:C-Reactive Protein