Neutrophil infiltration of culprit lesions in acute coronary syndromes
Neutrophil infiltration of culprit lesions in acute coronary syndromes
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DOI：
10.1161/01.cir.0000042674.89762.20
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发表时间：
2002-12-03
期刊：
影响因子：
37.8
通讯作者：
Becker, AE
中科院分区：
文献类型：
--
作者：
Naruko, T;Ueda, M;Becker, AE
背景-中性粒细胞在不稳定的动脉粥样硬化病变并没有得到太多的考虑，尽管积累的证据表明全身炎症和急性冠状动脉syndromes.Methods和Results-Coronary动脉节段获得尸检从13例急性心肌梗死（AMI）; 8个破裂和5个侵蚀斑块。非心血管疾病死亡的患者（n = 45）作为参考。从35例稳定型心绞痛（SAP）和32例不稳定型心绞痛（UAP）患者中获得动脉粥样硬化切除标本。抗CD 66 b、弹性蛋白酶、髓过氧化物酶和CD 11b的抗体鉴定中性粒细胞; CD 10鉴定中性内肽酶（NEP）。计数CD 66 b阳性和NEP阳性中性粒细胞，并表示为每平方毫米组织的数量。所有斑块破裂或糜烂的标本均显示明显的中性粒细胞浸润;破裂和糜烂斑块之间的数量没有差异。然而，破裂斑块中NEP阳性中性粒细胞的数量显著高于糜烂斑块（P < 0.0001）。UAP患者在32个罪犯病变中的14个中显示出中性粒细胞;在SAP中，35个病变中仅2个含有中性粒细胞。UAP患者的中性粒细胞和NEP阳性细胞数量明显高于SAP患者（中性粒细胞，P < 0.0005; NEP阳性细胞，P < 0.005）。结论-观察表明中性粒细胞浸润与急性冠状动脉事件密切相关。破裂斑块中NEP阳性中性粒细胞的数量高于糜烂斑块，这可能反映了潜在的病理生理机制的差异。
Background-Neutrophils in unstable atherosclerotic lesions have not received much consideration, despite accumulating evidence suggesting a link between systemic inflammation and acute coronary syndromes.Methods and Results-Coronary artery segments were obtained at autopsy from 13 patients with acute myocardial infarction (AMI); 8 had a ruptured and 5 an eroded plaque. Patients (n = 45) who had died of noncardiovascular diseases served as reference. Atherectomy specimens were obtained from 35 patients with stable angina pectoris (SAP) and from 32 patients with unstable angina pectoris (UAP). Antibodies against CD66b, elastase, myeloperoxidase, and CD11b identified neutrophils; CD10 identified neutral endopeptidase (NEP). CD66b-positive and NEP-positive neutrophils were counted and expressed as a number per square millimeter of tissue. All specimens with plaque rupture or erosion showed distinct neutrophil infiltration; the number did not differ between ruptured and eroded plaques. However, the number of NEP-positive neutrophils was significantly higher (P < 0.0001) in ruptured plaques than in eroded plaques. UAP patients showed neutrophils in 14 of 32 culprit lesions; in SAP only 2 of 35 lesions contained neutrophils. The number of neutrophils and NEP-positive cells in patients with UAP was significantly higher (neutrophils, P < 0.0005; NEP-positive cells, P < 0.005) than in patients with SAP.Conclusions-The observations suggest that neutrophil infiltration is actively associated with acute coronary events. The high number of NEP-positive neutrophils in ruptured plaques, compared with eroded plaques, may reflect differences in the underlying pathophysiological mechanisms.