B-Lymphocytes in plaque and adventitia of coronary arteries in two patients with rheumatoid arthritis and coronary atherosclerosis: preliminary observations.
OBJECTIVE
To describe the subtypes of lymphocytes in coronary arteries of two patients with rheumatoid arthritis (RA) and coronary artery disease (CAD).


METHODS
The Mayo Clinic database was searched for patients with RA and CAD who underwent an autopsy in 2001. Medical records were reviewed, and coronary arteries were examined microscopically. The percentage of B- and T-lymphocytes was determined using histomorphometry on representative sections stained with CD20 and CD3 antibodies, respectively.


RESULTS
Two men were diagnosed with RA at ages 52 and 70 years and died at ages 60 and 82 years. One sustained an acute myocardial infarction 2 years prior to the diagnosis of RA and had stable CAD until an arrhythmic death. The other developed congestive heart failure secondary to ischemic heart disease 5 years after RA was diagnosed. Both patients had severe three-vessel CAD with both stable fibrocalcific plaques and acute lesions. B- and T-lymphocytes were identified in the plaque and adventitia of all coronary arteries. The mean percentage of B-lymphocytes was 37% to 52% in the plaque and 78% to 85% in the adventitia, while that of T-lymphocytes was 38% to 51% and 28%, for plaque and adventitia, respectively.


CONCLUSIONS
In typical CAD, lymphocytic infiltrates are almost exclusively T-cells. In contrast, the two patients with RA and CAD showed prominent infiltrates of B-lymphocytes within plaques and adventitia. Thus, the leukocytic response in atherosclerotic plaques may be altered in patients with autoimmune disorders. This warrants further study.
Aubry
Marie-Christine
MC
Division of Anatomic Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. aubry.mariechristine@mayo.edu
Riehle
Darren L
DL
Edwards
William D
WD
Maradit-Kremers
Hilal
H
Roger
Veronique L
VL
Sebo
Thomas J
TJ
Gabriel
Sherine E
SE
D000368:Aged; D000369:Aged, 80 and over; D018951:Antigens, CD20 / Q000378:metabolism; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000276:immunology* / Q000473:pathology; D001402:B-Lymphocytes / Q000276:immunology*; D017252:CD3 Complex / Q000378:metabolism; D003238:Connective Tissue / Q000276:immunology / Q000473:pathology; D003324:Coronary Artery Disease / Q000150:complications / Q000276:immunology* / Q000473:pathology; D003331:Coronary Vessels / Q000276:immunology / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D016131:Lymphocyte Subsets / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology*
D018951:Antigens, CD20; D017252:CD3 Complex