title: Altered trafficking of CD8+ memory T cells after implantation of rapamycin-eluting stents in patients with coronary artery disease.
abstract: Aim of this study was to investigate the effects of implantation of different coronary drug-eluting stents on trafficking of central (T(CM)) or effector (T(EM)) memory T cells in the coronary sinus of patients with coronary artery disease (CAD) undergoing percutaneous coronary revascularization. Thirty-two patients presenting with stable coronary disease and angiographically proven stenosis of left descending coronary artery were randomly assigned to treatment with rapamycin-eluting, paclitaxel-eluting or bare metal stents. Heparinized blood samples were obtained from the coronary sinus either before or 20 min after stent implantation. Mononuclear cells were stained with mAbs specific for CD3, CD4, CD8, CD45R0, and CD27 molecules. Analysis of surface phenotype was performed by four-color flow cytometry and data on both CD4+ and CD8+ T(CM) and T(EM) cells were expressed either as absolute cell numbers/microL of blood or as percentages relative to the corresponding total memory T cell populations in the individual patients. We found that the number of CD8+ T(EM), as defined by CD3+CD45R0+CD8+CD27- phenotype, was significantly reduced in patients receiving a rapamycin-eluting stent as compared with basal values. Conversely, the number of CD8+ T(CM) (CD3+CD45R0+CD8+CD27+) was increased in the same treatment group after the revascularization procedure. No changes in the absolute number of CD4+ and CD8+ total (T(CM) plus T(EM)) memory T cells before and after the procedure were observed. These findings suggest that rapamycin eluted from medicated coronary stents rapidly induce a redistribution of memory CD8+ T lymphocyte subsets, with a significant decrease of T(EM) and a corresponding increase of T(CM) increase circulating within the coronary sinus. This anti-inflammatory effect could partially explain the reduction of coronary in-stent restenosis rate associated with the clinical use of this type of device.
authors.affiliation: Dipartimento di Scienze Cardiovascolari e Respiratorie, Università di Roma La Sapienza, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Sardella
authors.forename: Daniele
authors.initials: D
authors.lastname: Accapezzato
authors.forename: Angelo
authors.initials: A
authors.lastname: Di Roma
authors.forename: Vittorio
authors.initials: V
authors.lastname: Francavilla
authors.forename: Cristian
authors.initials: C
authors.lastname: Di Russo
authors.forename: Gino
authors.initials: G
authors.lastname: Iannucci
authors.forename: Maria Isabella
authors.initials: MI
authors.lastname: Sirinian
authors.forename: Laura
authors.initials: L
authors.lastname: Giacomelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Fedele
authors.forename: Marino
authors.initials: M
authors.lastname: Paroli
mesh_terms: D000368:Aged; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology*; D002465:Cell Movement / Q000187:drug effects / Q000276:immunology*; D003324:Coronary Artery Disease / Q000276:immunology* / Q000628:therapy; D005434:Flow Cytometry; D006801:Humans; D007156:Immunologic Memory / Q000276:immunology*; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D008875:Middle Aged; D017239:Paclitaxel / Q000494:pharmacology; D020123:Sirolimus / Q000494:pharmacology*; D015607:Stents
chemical_list: D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus