(Circulation. 1999;100:2135.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
From the Departments of Medicine (G.L., S.L.K., R.L.F., J.J.G., C.M.W.) and Biostatistics (W.M.O.), Mayo Clinic, Rochester, Minn; and the Division of Cardiology (A.M.), Catholic University, Rome, Italy.
Correspondence and reprint requests to C.M. Weyand, MD, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905. E-mail weyand.cornelia{at}mayo.edu
BackgroundMonocytes are
constitutively activated in unstable angina (UA), resulting in
the production of IL-6 and the upregulation of acute phase
proteins. Underlying mechanisms are not understood. To explore whether
the production of the potent monocyte activator
IFN-
is altered in UA, we compared cytokine
production by T lymphocytes in patients with UA (Braunwalds
class IIIB) and with stable angina (SA).
Methods and ResultsPeripheral blood lymphocytes were
collected at the time of hospitalization and after 2 and 12 weeks.
Cytokine-producing CD4+ and CD8+ T
cells were quantified by 3-color flow cytometry after stimulation with
phorbol myristate acetate and ionomycin. UA was associated with
an increased number of CD4+ and CD8+ T cells
producing IFN-
, whereas patients with SA had higher frequencies of
IL-2+ and IL-4+ CD4+ T cells.
Expansion of the IFN-
+ T-cell population in UA
persisted for at least 3 months. Increased production of
IFN-
in UA could be attributed to the expansion of an unusual subset
of T cells, CD4+CD28null T cells.
ConclusionsPatients with UA are characterized by a perturbation
of the functional T-cell repertoire with a bias toward IFN-
production, suggesting that monocyte activation and acute phase
responses are consequences of T-cell activation. IFN-
is produced by
CD4+CD28null T cells, which are expanded in UA
and distinctly low in SA and controls. The emergence of
CD4+CD28null T cells may result from persistent
antigenic stimulation.
Key Words: angina ischemia interleukins immune system lymphocytes
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