title: Reduction and activation of circulating dendritic cells in patients with decompensated heart failure.
abstract: BACKGROUND
  Dendritic cells (DCs) are the most potent antigen-presenting cells and play a central role in initiating the primary immune response. Although increasing evidence supports immune-mediated inflammation plays an important role in the pathophysiology of heart failure, little is known regarding the source and mechanism that trigger immune responses. The present study examined whether circulating DCs have any role in the pathophysiology in heart failure in humans.
  
  
  RESULTS
  With multi-color flow cytometry we determined the numbers of circulating myeloid DCs (mDCs) and plasmacytoid DCs (pDCs) in decompensated heart failure patients with NYHA class III or IV on admission (n = 27) and the age-similar control subjects (n = 21). DC activation markers such as CD40, and CCR7 were also measured. On admission, circulating mDC and pDC counts were significantly lower in decompensated heart failure patients compared to control subjects (p < 0.01). Circulating mDCs and pDCs were activated in the decompensated heart failure patients. Heart failure treatment restored the reduction and the activation of circulating mDCs and pDCs (p < 0.05). The increases of circulating DCs numbers after treatment were correlated with the decreases in B-type natriuretic peptide (BNP) and troponin-T (p < 0.05) and with the increase in left ventricular ejection fraction (LVEF) (p < 0.01). Furthermore, we found that poor recovery of the circulating DCs number after treatment predicted recurrence of decompensated heart failure.
  
  
  CONCLUSIONS
  These findings suggest that the reduction and activation of circulating DCs may be involved in the pathophysiology of heart failure.
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University, 67 Asahi-machi, Kurume 830-0011, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sugi
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasukawa
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kai
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fukui
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Futamata
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Mawatari
authors.forename: Toyoharu
authors.initials: T
authors.lastname: Oba
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Nagata
authors.forename: Sachiko
authors.initials: S
authors.lastname: Kyougoku
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Koga
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Imaizumi
mesh_terms: D000368:Aged; D002452:Cell Count; D003713:Dendritic Cells / Q000166:cytology* / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D005455:Fluorescent Antibody Technique; D006333:Heart Failure / Q000276:immunology* / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests