title: Neopterin, CD4+CD28- lymphocytes and the extent and severity of coronary artery disease.
abstract: OBJECTIVE
  Macrophages and pro-inflammatory CD3+CD4+CD28- T lymphocytes are involved in atherosclerotic plaque destabilization. Whether neopterin, a macrophage-specific activation-marker, and circulating CD3+CD4+CD28- cells are also related to the severity and extent of coronary artery disease (CAD) in stable patients is still unclear.
  
  
  METHODS
  Coronary angiograms of 30 patients with stable angina pectoris were graded using the Gensini severity and an extent score. Patients were grouped according to the median of each score. Lymphocyte subsets were determined by FACS analysis and neopterin by radioimmunoassay. Peripheral endothelial function of the brachial artery (FMD) shown to correlate with cardiovascular risk factors was evaluated using high-resolution ultrasound.
  
  
  RESULTS
  More extensive CAD was associated with increased neopterin levels (8.3 +/- 3.3 vs. 5.5 +/- 1.2 nmol/L, p < 0.001) and increased CD3+CD4+CD28- cells (3.1 +/- 1.6 vs. 2.0 +/- 1.2%, p < 0.05). A high Gensini severity score was associated with increased neopterin levels (7.8 +/- 2.7 vs. 6.3 +/- 1.7 nmol/L, p < 0.05), but not with CD3+CD4+CD28- cells. Neopterin correlated with both the extent (r = 0.59, p < 0.001) and the Gensini score (r = 0.57, p < 0.003). FMD was not correlated with both scores.
  
  
  CONCLUSIONS
  Neopterin and CD3+CD4+CD28- lymphocytes are associated with CAD extent in stable patients, thereby emphasizing the inherent role of inflammation in atherogenesis itself beyond plaque destabilization. Neopterin's correlation with CAD severity might be additionally useful in identifying patients eligible for revascularization procedures.
authors.affiliation: Division of Cardiology, Innsbruck Medical University, Austria. Hannes.Alber@uki.at
authors.forename: Hannes F
authors.initials: HF
authors.lastname: Alber
authors.forename: Christina
authors.initials: C
authors.lastname: Duftner
authors.forename: Maria
authors.initials: M
authors.lastname: Wanitschek
authors.forename: Jakob
authors.initials: J
authors.lastname: Dörler
authors.forename: Michael
authors.initials: M
authors.lastname: Schirmer
authors.forename: Alois
authors.initials: A
authors.lastname: Suessenbacher
authors.forename: Matthias
authors.initials: M
authors.lastname: Frick
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Dichtl
authors.forename: Otmar
authors.initials: O
authors.lastname: Pachinger
authors.forename: Franz
authors.initials: F
authors.lastname: Weidinger
mesh_terms: D000328:Adult; D000368:Aged; D001916:Brachial Artery / Q000502:physiology; D018106:CD28 Antigens / Q000378:metabolism; D017252:CD3 Complex / Q000378:metabolism; D015704:CD4 Antigens / Q000378:metabolism; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000378:metabolism; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000276:immunology*; D004730:Endothelium, Vascular / Q000502:physiology; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D016131:Lymphocyte Subsets / Q000276:immunology / Q000378:metabolism; D008264:Macrophages / Q000276:immunology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000097:blood*; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D018106:CD28 Antigens; D017252:CD3 Complex; D015704:CD4 Antigens; D019798:Neopterin