Association of Toll-Like Receptor 4 on Human Monocyte Subsets and Vulnerability Characteristics of Coronary Plaque as Assessed by 64-Slice Multidetector Computed Tomography.
Although Toll-like receptor 4 (TLR-4) is involved in monocyte activation in patients with accelerated forms of atherosclerosis, the relationship between the expression of TLR-4 on circulating monocytes and coronary plaque vulnerability has not previously been evaluated. We investigated this relationship using 64-slice multidetector computed tomography (MDCT) in patients with stable angina pectoris (SAP).



We enrolled 65 patients with SAP who underwent MDCT. Three monocyte subsets (CD14++CD16-, CD14++CD16+, and CD14+CD16+) and expression of TLR-4 were measured by flow cytometry. Intracoronary plaques were assessed by 64-slice MDCT. We defined vulnerability of intracoronary plaques according to the presence of positive remodeling (remodeling index >1.05) and/or low CT attenuation (<35 HU). The circulating CD14++CD16+monocytes more frequently expressed TLR-4 than CD14++CD16-and CD14+CD16+monocytes (P<0.001). The relative proportion of the expression of TLR-4 on CD14++CD16+monocytes was significantly greater in patients with vulnerable plaque compared with those without (10.4 [4.1-14.5] % vs. 4.5 [2.8-7.8] %, P=0.012). In addition, the relative proportion of TLR-4 expression on CD14++CD16+monocytes positively correlated with the remodeling index (r=0.28, P=0.025) and negatively correlated with CT attenuation value (r=-0.31, P=0.013).



Upregulation of TLR-4 on CD14++CD16+monocytes might be associated with coronary plaque vulnerability in patients with SAP.
Department of Cardiovascular Medicine, Wakayama Medical University.
Yuichi
Y
Ozaki
Department of Cardiovascular Medicine, Wakayama Medical University.|Department of Cardiovascular Medicine, Hidaka General Hospital.
Toshio
T
Imanishi
Department of Cardiovascular Medicine, Wakayama Medical University.
Seiki
S
Hosokawa
Department of Cardiovascular Medicine, Wakayama Medical University.
Tsuyoshi
T
Nishiguchi
Department of Cardiovascular Medicine, Wakayama Medical University.
Akira
A
Taruya
Department of Cardiovascular Medicine, Wakayama Medical University.
Takashi
T
Tanimoto
Department of Cardiovascular Medicine, Wakayama Medical University.
Akio
A
Kuroi
Department of Cardiovascular Medicine, Wakayama Medical University.
Takashi
T
Yamano
Department of Cardiovascular Medicine, Wakayama Medical University.
Yoshiki
Y
Matsuo
Department of Cardiovascular Medicine, Wakayama Medical University.
Yasushi
Y
Ino
Department of Cardiovascular Medicine, Wakayama Medical University.
Hironori
H
Kitabata
Department of Cardiovascular Medicine, Wakayama Medical University.
Takashi
T
Kubo
Department of Cardiovascular Medicine, Wakayama Medical University.
Atsushi
A
Tanaka
Department of Cardiovascular Medicine, Wakayama Medical University.
Takashi
T
Akasaka
D000368:Aged; D060050:Angina, Stable / Q000097:blood / Q000000981:diagnostic imaging; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging; D005260:Female; D005434:Flow Cytometry; D058851:GPI-Linked Proteins / Q000097:blood; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000097:blood; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism* / Q000473:pathology; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000000981:diagnostic imaging; D017452:Receptors, IgG / Q000097:blood; D051197:Toll-Like Receptor 4 / Q000097:blood*; D014057:Tomography, X-Ray Computed; D015854:Up-Regulation
C428200:FCGR3B protein, human; D058851:GPI-Linked Proteins; D018950:Lipopolysaccharide Receptors; D017452:Receptors, IgG; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4
Monocytes; Multidetector computed tomography (MDCT); Plaque vulnerability; Toll-like receptor 4