title: Patients with acute coronary syndrome show oligoclonal T-cell recruitment within unstable plaque: evidence for a local, intracoronary immunologic mechanism.
abstract: BACKGROUND
  Recent studies indicate that T-cell activation may play an important role in the pathophysiology of acute coronary syndromes (ACS). However, although those studies detected T-cell expansion in peripheral blood cells, demonstration of specific T-cell expansion within the plaque of patients with ACS is lacking. The present study aims to address whether a specific, immune-driven T-lymphocyte recruitment occurs within the unstable plaque of patients with ACS.
  
  
  RESULTS
  We simultaneously examined the T-cell repertoire using CDR3 size analysis both in coronary plaques (obtained by directional atherectomy) and in peripheral blood of patients with either ACS (n=11) or chronic stable angina (n=10). Unstable plaques showed a 10-fold increase in T-cell content by quantitative PCR. Using spectratyping analysis, we found several specific T-cell clonotype expansions only in unstable plaque from each patient with ACS, indicating a specific, antigen-driven recruitment of T cells within unstable lesions.
  
  
  CONCLUSIONS
  For the first time, T-cell repertoire was investigated directly into coronary plaques; using this approach, we demonstrate that coronary plaque instability in the setting of ACS is associated with immune-driven T-cell recruitment, specifically within the plaque.
authors.affiliation: Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Palma
authors.forename: Francesco
authors.initials: F
authors.lastname: Del Galdo
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Abbate
authors.forename: Massimo
authors.initials: M
authors.lastname: Chiariello
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabró
authors.forename: Lavinia
authors.initials: L
authors.lastname: Forte
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cimmino
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Papa
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Russo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ambrosio
authors.forename: Claudio
authors.initials: C
authors.lastname: Giombolini
authors.forename: Isabella
authors.initials: I
authors.lastname: Tritto
authors.forename: Salvatore
authors.initials: S
authors.lastname: Notaristefano
authors.forename: Liberato
authors.initials: L
authors.lastname: Berrino
authors.forename: Francesco
authors.initials: F
authors.lastname: Rossi
authors.forename: Paolo
authors.initials: P
authors.lastname: Golino
mesh_terms: D000208:Acute Disease; D000368:Aged; D050197:Atherosclerosis / Q000276:immunology / Q000473:pathology; D049109:Cell Proliferation; D002634:Chemotaxis, Leukocyte; D002999:Clone Cells; D022801:Complementarity Determining Regions; D003327:Coronary Disease / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D037182:T-Cell Antigen Receptor Specificity; D013601:T-Lymphocytes / Q000502:physiology*
chemical_list: D022801:Complementarity Determining Regions