title: Expression of monocyte subsets and angiogenic markers in relation to carotid plaque neovascularization in patients with pre-existing coronary artery disease and carotid stenosis.
abstract: OBJECTIVE
  To characterize blood monocyte subsets in patients with different degrees of carotid atherosclerosis and pathological carotid plaque neovascularization.
  
  
  METHODS
  Assessment of carotid plaque neovascularization using contrast ultrasonography and flow cytometric quantification of monocyte subsets and their receptors involved in inflammation, angiogenesis, and tissue repair was done in 40 patients with carotid stenosis ≥ 50% and CAD (CS > 50), 40 patients with carotid stenosis < 50% and documented CAD (CS < 50), 40 hypercholesterolaemic controls (HC group), and 40 normocholesterolaemic controls (NC).
  
  
  RESULTS
  CS > 50 and CS < 50 groups had increased counts of Mon1 ('classical' CD14++ CD16-CCR2 + cells) compared to HCs (P = 0.03, and P = 0.009). Mon3 ('non-classical' CD14 + CD16++ CCR2- cells) were only increased in CS < 50 compared with HCs (P < 0.01). Both CS>50 and CS < 50 groups showed increased expression of proinflammatory interleukin-6 receptor on Mon1 and Mon2 ('intermediate' CD14++ CD16 + CCR2+ cells); TLR4, proangiogenic Tie2 on all subsets (P < 0.01 for all). In multivariate regression analysis only high Mon1 count was a significant predictor of carotid stenosis (P = 0.04) and intima-media thickness (P = 0.02). In multivariate regression analysis only the Mon1 subset was significantly associated with severe, grade 2 neovascularization (P = 0.034).
  
  
  CONCLUSIONS
  In this pilot study classical monocytes (Mon1) represent the only monocyte subset predictive of the severity of carotid and systemic atherosclerosis, such as carotid intima-media thickness, degree of carotid stenosis, and presence of carotid intraplaque neovascularization.
authors.affiliation: University of Birmingham Centre for Cardiovascular Sciences, City Hospital , Birmingham, B18 7QH, England , United Kingdom.
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Jaipersad
authors.forename: Alena
authors.initials: A
authors.lastname: Shantsila
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.forename: Eduard
authors.initials: E
authors.lastname: Shantsila
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D016893:Carotid Stenosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D003327:Coronary Disease / Q000097:blood* / Q000209:etiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood; D007249:Inflammation / Q000097:blood; D007958:Leukocyte Count; D018950:Lipopolysaccharide Receptors / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000737:chemistry*; D009389:Neovascularization, Pathologic / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D010865:Pilot Projects; D042787:Receptor, TIE-2 / Q000032:analysis; D054390:Receptors, CCR2 / Q000032:analysis; D017452:Receptors, IgG / Q000032:analysis; D019947:Receptors, Interleukin-6 / Q000032:analysis; D012720:Severity of Illness Index; D051197:Toll-Like Receptor 4 / Q000032:analysis
chemical_list: C515334:CCR2 protein, human; D018950:Lipopolysaccharide Receptors; D054390:Receptors, CCR2; D017452:Receptors, IgG; D019947:Receptors, Interleukin-6; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4; D042787:Receptor, TIE-2
keywords: Carotid atherosclerosis; carotid contrast ultrasound; carotid stenosis; coronary heart disease; monocyte subsets; plaque neovascularization