Author + information
- Ales Pleskovic1,
- Olga Vraspir Porenta2,
- Ruda Zorc Pleskovic2,
- Aleksandra Milutinovic2,
- Danijel Petrovic2 and
- Marjeta Zorc3
In the last decades morphologic investigations of coronary artery disease (CAD) have been mainly focused on histological changes in intimal endothelial cells and subendothelial space, whereas in the last years there is growing interest in histological changes of other layers of the vascular wall in the pathogenesis of atherosclerotic process.
Our study is focused on the immunohistochemical identification of immune cells: lymphocytes T, lymphocytes B and macrophages and their influence on morphologic degree of atherosclerosis in surgically obtained endarterectomies of patients with diffuse obstructive CAD.
Coronary endarterectomy was performed in 42 symptomatic male patients with diffuse obstructive CAD, aged from 60 to 72 years. All patients had mildly increased CRP whereas subjects with other risk factors were not included (arterial hypertension, diabetes, cigarette smoking, hypercholesterolemia). The degree of atherosclerosis was evaluated according to the Starry’s classification.
Morphologic analysis of paraffin sections of vessels stained with hematoxylin and eosin revealed diffuse fibroproliferative changes in intima and focal or diffuse cellular infiltration in tunica adventitia and media. Morphometric analysis of immunohistochemically treated vessels demonstrated 65% of macrophages 20% of T lymphocytes and 15% of B lymphocytes in tunica adventitia. In tunica media there were 2% of macrophages, 67% of T lymphocytes and 31 % B lymphocytes. In diffusely atherosclerotic intima there were similar numbers of cells as in the adventitia with a prevalence of 60% macrophages, 27% of T lymphocytes and 13% of B lymphocytes. Statistical analysis showed negative correlation between number of immune cells (T lymphocytes and B lymphocytes) in tunica media and the degree of diffuse atherosclerotic process.
Our results showed that in the advanced diffuse atherosclerosis of coronary arteries, immunological activity is a continuous processes in which mainly T lymphocytes and B lymphocytes in tunica media are involved. A lower number of immune cells in tunica media is associated with a significantly higher degree of atherosclerosis.