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Circulation. 1999;100:2135-2139

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(Circulation. 1999;100:2135.)
© 1999 American Heart Association, Inc.


Clinical Investigation and Reports

Perturbation of the T-Cell Repertoire in Patients With Unstable Angina

Giovanna Liuzzo, MD; Stephen L. Kopecky, MD; Robert L. Frye, MD; W. Michael O’ Fallon, PhD; Attilio Maseri, MD; Jorg J. Goronzy, MD; Cornelia M. Weyand, MD

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

Background—Monocytes 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-{gamma} is altered in UA, we compared cytokine production by T lymphocytes in patients with UA (Braunwald’s class IIIB) and with stable angina (SA).

Methods and Results—Peripheral 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-{gamma}, whereas patients with SA had higher frequencies of IL-2+ and IL-4+ CD4+ T cells. Expansion of the IFN-{gamma} + T-cell population in UA persisted for at least 3 months. Increased production of IFN-{gamma} in UA could be attributed to the expansion of an unusual subset of T cells, CD4+CD28null T cells.

Conclusions—Patients with UA are characterized by a perturbation of the functional T-cell repertoire with a bias toward IFN-{gamma} production, suggesting that monocyte activation and acute phase responses are consequences of T-cell activation. IFN-{gamma} 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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CirculationHome page
K. Raza, J. Thambyrajah, J. N. Townend, A. R. Exley, C. Hortas, A. Filer, D. M. Carruthers, and P. A. Bacon
Suppression of Inflammation in Primary Systemic Vasculitis Restores Vascular Endothelial Function: Lessons for Atherosclerotic Disease?
Circulation, September 26, 2000; 102(13): 1470 - 1472.
[Abstract] [Full Text] [PDF]


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CirculationHome page
G. Liuzzo, J. J. Goronzy, H. Yang, S. L. Kopecky, D. R. Holmes, R. L. Frye, and C. M. Weyand
Monoclonal T-Cell Proliferation and Plaque Instability in Acute Coronary Syndromes
Circulation, June 27, 2000; 101(25): 2883 - 2888.
[Abstract] [Full Text] [PDF]


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J. Immunol.Home page
A. N. Vallejo, L. O. Mugge, P. A. Klimiuk, C. M. Weyand, and J. J. Goronzy
Central Role of Thrombospondin-1 in the Activation and Clonal Expansion of Inflammatory T Cells
J. Immunol., March 15, 2000; 164(6): 2947 - 2954.
[Abstract] [Full Text] [PDF]


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CirculationHome page
V. Pasceri and E. T. H. Yeh
A Tale of Two Diseases : Atherosclerosis and Rheumatoid Arthritis
Circulation, November 23, 1999; 100(21): 2124 - 2126.
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J. Biol. Chem.Home page
A. N. Vallejo, C. M. Weyand, and J. J. Goronzy
Functional Disruption of the CD28 Gene Transcriptional Initiator in Senescent T Cells
J. Biol. Chem., January 19, 2001; 276(4): 2565 - 2570.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
N. Marx, B. Kehrle, K. Kohlhammer, M. Grub, W. Koenig, V. Hombach, P. Libby, and J. Plutzky
PPAR Activators as Antiinflammatory Mediators in Human T Lymphocytes: Implications for Atherosclerosis and Transplantation-Associated Arteriosclerosis
Circ. Res., April 5, 2002; 90(6): 703 - 710.
[Abstract] [Full Text] [PDF]