Increased endothelial cell apoptosis in symptomatic high-grade carotid artery stenosis: preliminary data.
OBJECTIVE
Endothelial cell (EC) apoptosis has been associated with thrombus formation on an eroded atherosclerotic plaque surface. Alongside plaque rupture, it may constitute another mechanism of plaque destabilisation. We investigated whether EC apoptosis also may be involved in plaque destabilisation in high-grade internal carotid artery (ICA) stenosis.


METHODS
We compared the degree of EC apoptosis in carotid endarterectomy specimens from n=38 patients undergoing surgery for high-grade ICA stenosis (> or =70%; n=19 clinically asymptomatic; n=19 symptomatic). The total number of endothelial cells (ECs) and apoptotic cells were determined using CD31 immunohistochemistry and the TdT dUTP nick end-labeling (TUNEL) method respectively.


RESULTS
Overall, EC apoptosis was a rare finding. The median percentage of apoptotic ECs was 0.0% (0.0-0.7%) in asymptomatic and 0.5% (0.0-7.3%) in symptomatic plaques (p=0.015, Mann-Whitney U test). No difference was observed between ruptured and unruptured plaque (0.0% [0.0-6.0%] vs 0.0% [0.0-5.7%]; p=0.446).


CONCLUSIONS
Our results indicate that TUNEL-detected EC apoptosis is rare in carotid plaque from patients with >70% stenosis.
Trostdorf
F
F
Departments of Neurology, JW Goethe University Frankfurt am Main, Germany. f.trostdorf@em.uni-frankfurt.de
Landgraf
C
C
Kablau
M
M
Schmitz-Rixen
T
T
Sitzer
M
M
D000368:Aged; D017209:Apoptosis; D002343:Carotid Artery, Internal / Q000473:pathology*; D016893:Carotid Stenosis / Q000473:pathology* / Q000503:physiopathology; D042783:Endothelial Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D020287:In Situ Nick-End Labeling; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012422:Rupture, Spontaneous; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric