The impact of splenectomy on human coronary artery atherosclerosis and vascular macrophage distribution
The impact of splenectomy on human coronary artery atherosclerosis and vascular macrophage distribution
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DOI：
10.1016/j.carpath.2016.08.001
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发表时间：
2016-11-01
影响因子：
3.7
通讯作者：
Stone, James R.
中科院分区：
文献类型：
--
作者：
Li, Yu;Stone, James R.
背景资料：脾切除术可能通过多种机制影响动脉粥样硬化，包括改变脂质稳态，增加凝血和改变巨噬细胞向斑块的募集。在患者中，脾切除术与冠状动脉事件的发生率增加有关，而在实验小鼠中，脾切除术导致动脉粥样硬化增加，但减少了全身单核细胞供应。在这项研究中，脾切除术对人冠状动脉粥样硬化斑块的严重程度和巨噬细胞含量的直接影响investigated.Methods：冠状动脉粥样硬化斑块的严重程度进行了测定，在18个长期（>= 10年）脾切除术患者和90个匹配的对照组患者尸检。在11名中长期（>= 1年）脾切除术患者和11名匹配的对照患者的轻度动脉粥样硬化斑块中评价冠状动脉巨噬细胞含量。结果：脾切除术与冠状动脉粥样硬化减少相关（P = .03）。在死亡前20年或更长时间接受脾切除术的患者亚组中，这种相关性最明显（P = .02）。在比较脾切除术和对照组患者时，斑块、中膜或外膜中的巨噬细胞密度没有差异。在对照组中，三个动脉层中的巨噬细胞密度之间没有相关性。然而，在脾切除术患者中，穿过斑块、中膜和外膜的巨噬细胞密度有很强的相关性（P = .0002），结果斜率显著大于对照组患者（P = 0.0007 - 0.011）.结论：这些发现表明，在人类中，脾切除术与较低的冠状动脉粥样硬化斑块严重程度和改变的冠状动脉巨噬细胞分布有关。这些结果表明，脾脏可以调节巨噬细胞进入人冠状动脉的募集和动脉粥样硬化的进展。(C)2016 Elsevier Inc. All rights reserved.
Background: Splenectomy can potentially impact atherosclerosis through multiple mechanisms including altered lipid homeostasis, increased coagulation, and altered macrophage recruitment to the plaque. In patients, splenectomy has been associated with increased rates of coronary artery events, while in experimental mice, splenectomy causes increased atherosclerosis but reduces systemic monocyte supply. In this study, the direct impact of splenectomy on human coronary artery atherosclerotic plaque severity and macrophage content was investigated.Methods: Coronary artery atherosclerotic plaque severity was determined at autopsy in 18 long-term (>= 10 years) splenectomy patients and 90 matched control patients. Coronary artery macrophage content was evaluated in mild atherosclerotic plaques of 11 mid-to long-term (>= 1 year) splenectomy patients and 11 matched control patients.Results: Splenectomy was associated with reduced coronary artery atherosclerosis (P = .03). The association was most pronounced for the subgroup of patients who had undergone splenectomy 20 years or more prior to death (P = .02). There was no difference in the density of macrophages in the plaque, media, or adventitia upon comparing splenectomy and control patients. In the control group, there was no correlation between the macrophage densities in the three arterial layers. However, in the splenectomy patients, there was a strong correlation in the macrophage densities across the plaque, media, and adventitia (P = .0002), with resulting slopes that were significantly greater than seen in the control patients (P = .0007-.011).Conclusions: These findings indicate that, in humans, splenectomy is associated with lower coronary artery atherosclerotic plaque severity and altered coronary artery macrophage distribution. These results suggest that the spleen can modulate the recruitment of macrophages into human coronary arteries and the progression of atherosclerosis. (C) 2016 Elsevier Inc. All rights reserved.