Circulation, Vol 88, 358-363, Copyright © 1993 by American Heart Association
A Mazzone, S De Servi, G Ricevuti, I Mazzucchelli, G Fossati, D Pasotti, E Bramucci, L Angoli, F Marsico and G Specchia
BACKGROUND. A rapid increase in leukocyte adhesion to endothelial cells is
one of the first events in the acute inflammatory response and in the
pathogenesis of vascular diseases. A subgroup of cell surface glycoproteins
(the CD11/CD18 complex) play a major role in the leukocyte adhesion
process; in particular, the CD11b/CD18 receptor can be upregulated
severalfold in response to chemotactic factors. The purpose of this study
was to assess whether upmodulation of granulocyte and monocyte CD11b/CD18
receptors takes place during the passage of blood through the coronary tree
of patients with clinical manifestations of ischemic heart disease. METHODS
AND RESULTS. Thirty- nine patients who underwent diagnostic coronary
arteriography were studied. Group 1 (15 patients) had a clinical diagnosis
of unstable angina, group 2 (14 patients) had stable exertional angina, and
group 3 (10 patients) had atypical chest pain. Simultaneous sampling from
the coronary sinus and aorta was obtained before coronary arteriography.
Cell surface receptors were detected by direct immunofluorescence evaluated
by flow cytofluorimetry using monoclonal antibodies tagged with fluorescent
markers. Leukocytes were stained in unseparated blood to avoid in vitro
manipulation that could activate phagocytes. Group 1 and 2 patients had
significant coronary artery disease (> 50% coronary narrowing in at
least one major coronary vessel), whereas group 3 patients had normal
coronary arteries. In group 1, granulocytes and monocytes showed a
significantly higher expression of the CD11b/CD18 adhesion receptor in the
coronary sinus than in the aorta (both P < .01), whereas no difference
in CD11b/CD18 expression was seen in groups 2 and 3. CONCLUSIONS. Patients
with unstable angina have an increased expression of granulocyte and
monocyte CD11b/CD18 adhesion receptors, indicating that an inflammatory
reaction takes place within their coronary tree. Activation of these
leukocytes may induce coronary vasoconstriction, favor thrombotic
processes, and further activate platelets, thus having potential
implications on the pathogenesis of unstable coronary artery disease.
ARTICLES
Increased expression of neutrophil and monocyte adhesion molecules in unstable coronary artery disease
Department of Internal Medicine and Therapeutics, IRCCS S Matteo Hospital, Pavia, Italy.
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