title: Decrease in circulating myeloid dendritic cell precursors in coronary artery disease.
abstract: OBJECTIVE
  We analyzed the frequency of myeloid dendritic cell (mDC) and plasmacytoid dendritic cell (pDC) precursors in blood of patients with coronary artery disease (CAD) and in atherosclerotic carotid plaques of patients with cerebrovascular disease (CVD).
  
  
  BACKGROUND
  Circulating DC precursors are reduced in several autoimmune diseases. Atherosclerosis has features of an autoimmune disease, such as the presence of autoantibodies or autoreactive T cells. Tissue-resident DCs were previously described in atheromata, and it is assumed that they are important for the activation of T cells against autoantigens there.
  
  
  METHODS
  Circulating mDC and pDC precursors were flow cytometrically detected in healthy controls (n = 19), CAD patients with stable (n = 20) and unstable angina pectoris (n = 19), and acute myocardial infarction (n = 17). In human carotid plaques (n = 65), mDC and pDC precursors were identified immunohistochemically.
  
  
  RESULTS
  Circulating mDC precursors were significantly reduced in patients with stable angina pectoris (0.19%, p = 0.04), unstable angina pectoris (0.16%, p = 0.004), and acute myocardial infarction (0.08%, p < 0.001) compared with control patients (0.22% of peripheral blood mononuclear cells). In contrast, pDC numbers were not significantly altered. Circulating mDC precursors inversely correlated with high-sensitivity C-reactive protein (r = -0.38, p = 0.001) or interleukin-6 (r = -0.42, p < 0.001). In contrast to pDC, significantly more mDC precursors were observed in vulnerable carotid plaques (24, 0.25 mm2; n = 31; p = 0.003) than in stable ones (6.4, 0.25 mm2; n = 34).
  
  
  CONCLUSIONS
  Similar to autoimmune diseases, circulating mDC precursors were significantly reduced in patients with CAD. The emergence of mDC precursors in vulnerable plaques suggests their recruitment into atheromata as a possible reason for their decrease in blood. In contrast, no significant association of circulating pDC precursors with atherosclerosis was observed.
authors.affiliation: Medical Clinic II, University of Erlangen-Nuremberg, Erlangen, Germany. A.Yilmaz.med2.uni-erlangen@email.de
authors.forename: Atilla
authors.initials: A
authors.lastname: Yilmaz
authors.forename: Jana
authors.initials: J
authors.lastname: Weber
authors.forename: Iwona
authors.initials: I
authors.lastname: Cicha
authors.forename: Christian
authors.initials: C
authors.lastname: Stumpf
authors.forename: Michael
authors.initials: M
authors.lastname: Klein
authors.forename: Dieter
authors.initials: D
authors.lastname: Raithel
authors.forename: Werner G
authors.initials: WG
authors.lastname: Daniel
authors.forename: Christoph D
authors.initials: CD
authors.lastname: Garlichs
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000276:immunology; D000789:Angina, Unstable / Q000097:blood / Q000276:immunology; D002097:C-Reactive Protein / Q000032:analysis; D051743:CCAAT-Enhancer-Binding Protein-delta; D016893:Carotid Stenosis / Q000097:blood / Q000276:immunology / Q000473:pathology; D002452:Cell Count; D003324:Coronary Artery Disease / Q000097:blood / Q000276:immunology* / Q000473:pathology; D003713:Dendritic Cells / Q000473:pathology*; D005260:Female; D005434:Flow Cytometry; D006412:Hematopoietic Stem Cells / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D015850:Interleukin-6; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000276:immunology
chemical_list: D015850:Interleukin-6; D051743:CCAAT-Enhancer-Binding Protein-delta; D002097:C-Reactive Protein