Inflammation and immune response in acute aortic dissection.
OBJECTIVE
The aim of our study was to evaluate the lymphocyte subpopulations and the cytokines in the peripheral blood of patients with type-A Stanford acute aortic dissection (AAD group) and to determine whether inflammatory cells are present at the site of aortic dissection.


METHODS
Thirty-five consecutive patients with type-A Stanford dissection were evaluated for haemochrome and lymphocyte subpopulations (CD3+, CD4+, CD8+, CD19+, CD4+CD25+, CD16+CD56+, CD4+CD28-, CD8+CD28-) by flow cytometry. C-reactive protein (CRP), tumour necrosis factor (TNF)-α, interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, interferon-gamma (IFN-γ), and monocyte chemoattractant protein (MCP)-1 were measured by ELISA. In addition, immunohistochemical staining with cell type-specific antibodies was performed to study the inflammatory cells detected inside the aortic wall.


RESULTS
In the AAD group, a significant increase in natural killer (NK) (P = 0.032), B cells (P = 0.022), and CD8+CD28- (P = 0.045) subpopulations was observed, whereas there was a significant decrease in total T lymphocytes (P = 0.004) and T helper fractions (P = 0.005). Moreover, a significant increase in CRP (P < 0.0001), IL-6 (P < 0.0001), IL-8 (P < 0.0001), IL-10 (P < 0.0001), TNF-α (P < 0.0001), and MCP-1 (P < 0.001) was observed; macrophages represented the main population detected inside the media.


CONCLUSIONS
Our results strongly support the hypothesis of a pivotal role of innate immunity in type-A Stanford AAD.
del Porto
Flavia
F
Dipartimento di Medicina Clinica e Molecolare, II Facoltà di Medicina e Chirurgia, Università La Sapienza, Ospedale Sant'Andrea, Via di Grottarossa 1035-1039, Rome, Italy. flavia.delporto@uniroma1.it
Proietta
Maria
M
Tritapepe
Luigi
L
Miraldi
Fabio
F
Koverech
Angela
A
Cardelli
Patrizia
P
Tabacco
Fabio
F
de Santis
Vincenzo
V
Vecchione
Andrea
A
Mitterhofer
Anna Paola
AP
Nofroni
Italo
I
Amodeo
Rachele
R
Trappolini
Massimo
M
Aliberti
Giuseppe
G
D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000097:blood / Q000150:complications / Q000276:immunology*; D001018:Aortic Diseases / Q000097:blood / Q000150:complications / Q000276:immunology*; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007113:Immunity, Innate; D007249:Inflammation / Q000150:complications / Q000276:immunology*; D018655:Lymphocyte Count; D008264:Macrophages; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D013602:T-Lymphocytes, Cytotoxic
D016207:Cytokines