title: Presence of B cells within aortic valves in patients with aortic stenosis: Relation to severity of the disease.
abstract: BACKGROUND
  Aortic stenosis (AS) shares several similarities with atherosclerosis. Recent reports showed that B cells are implicated in atherosclerosis progression through macrophage-B cells bidirectional interaction. We aimed to study the in loco presence of B cells within aortic valves and to determine its modulators.
  
  
  METHODS
  Thirty-seven patients with severe AS were studied. Immunohistochemistry was performed on valve leaflets using antibodies against CD20, B cell-activating factor of the tumor necrosis factor family receptor (BAFF-R) and CD68. Plasma inflammatory markers were also determined.
  
  
  RESULTS
  The B cells were detected within aortic leaflets from 5 to 31/mm(2) (17.9±11.6/mm(2)). Double-staining showed that 27±13.5% of B cells express BAFF-R. There were positive correlations between the number of B cells and macrophages (r=0.45, p=0.018), and between macrophages and B cell-associated BAFF-R expression (r=0.66, p=0.002). The number of B cells was associated with the valve calcification (r=0.41, p=0.039), and with the maximum transvalvular gradient (r=0.63, p=0.02). The BAFF-R expression was positively correlated with maximum transvalvular gradient (r=0.39, p=0.031) and negatively with aortic valve area (r=-0.41, p=0.048). There were no correlations between the number of B cells and plasma markers.
  
  
  CONCLUSIONS
  It might be hypothesized that, like in atherosclerosis, increasing number of B cells within aortic valves may accelerate inflammation and thus potentiate the progression of AS.
authors.affiliation: John Paul II Hospital, Krakow, Poland; Institute of Cardiology, Jagiellonian University School of Medicine, Krakow, Poland. Electronic address: j.natorska@szpitaljp2.krakow.pl.
authors.forename: Joanna
authors.initials: J
authors.lastname: Natorska
authors.affiliation: John Paul II Hospital, Krakow, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Marek
authors.affiliation: John Paul II Hospital, Krakow, Poland; Institute of Cardiology, Jagiellonian University School of Medicine, Krakow, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sadowski
authors.affiliation: John Paul II Hospital, Krakow, Poland; Institute of Cardiology, Jagiellonian University School of Medicine, Krakow, Poland.
authors.forename: Anetta
authors.initials: A
authors.lastname: Undas
mesh_terms: D001021:Aortic Valve / Q000378:metabolism / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000473:pathology*; D053265:B-Cell Activation Factor Receptor / Q000378:metabolism; D001402:B-Lymphocytes / Q000473:pathology*; D002114:Calcinosis / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008264:Macrophages / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D053265:B-Cell Activation Factor Receptor; C435926:TNFRSF13C protein, human
keywords: Aortic stenosis; B cells; Calcification; Inflammation