title: Inflammation and immune response in acute aortic dissection.
abstract: 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.
authors.affiliation: 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
authors.forename: Flavia
authors.initials: F
authors.lastname: del Porto
authors.forename: Maria
authors.initials: M
authors.lastname: Proietta
authors.forename: Luigi
authors.initials: L
authors.lastname: Tritapepe
authors.forename: Fabio
authors.initials: F
authors.lastname: Miraldi
authors.forename: Angela
authors.initials: A
authors.lastname: Koverech
authors.forename: Patrizia
authors.initials: P
authors.lastname: Cardelli
authors.forename: Fabio
authors.initials: F
authors.lastname: Tabacco
authors.forename: Vincenzo
authors.initials: V
authors.lastname: de Santis
authors.forename: Andrea
authors.initials: A
authors.lastname: Vecchione
authors.forename: Anna Paola
authors.initials: AP
authors.lastname: Mitterhofer
authors.forename: Italo
authors.initials: I
authors.lastname: Nofroni
authors.forename: Rachele
authors.initials: R
authors.lastname: Amodeo
authors.forename: Massimo
authors.initials: M
authors.lastname: Trappolini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Aliberti
mesh_terms: 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
chemical_list: D016207:Cytokines