Inflammation and activation of immune cells have important roles in the pathogenesis of atherosclerosis. We analyzed the plasma levels of inflammatory markers and the degree of activation of peripheral blood monocytes and T-lymphocytes isolated from 12 unstable angina, 12 stable angina, and 12 normal subjects. In 20%-33% of patients, monocytes expressed high basal levels of IL-8, tissue factor, IL-1beta, and monocyte chemoattractant protein-1 mRNA. Furthermore, basal mRNA levels of these cytokines showed strong correlation with each other (p < 0.01 in all combination) but not with tumor necrosis factor-alpha or transforming growth factor-beta1. Plasma level of C-reactive protein was highest in the unstable angina patients (1.63+/-0.70 mg/l) and lowest in the control subjects (0.22+/-0.08 mg/l) (P = 0.03). We also observed a high correlation between C-reactive protein level and the occurrence of minor and major coronary events during 6 months of follow-up. Activation status of T-cells, assessed by the percentage of HLA-DR positive cells, was highest in the unstable angina patients (26.8+/-1.4%) compared with that in the control (14.7+/-1.2%) (P = 0.0053). Our data represent the first case showing that the circulating monocytes in angina patients are activated to a state express numerous proatherogenic cytokines. These results may help to diagnose angina patients according to the inflammatory markers and evaluate the prognosis of the disease.
Aged ; Angina Pectoris/immunology* ; Angina Pectoris/diagnosis ; Angina, Unstable/immunology* ; Angina, Unstable/diagnosis ; Biological Markers/blood ; C-Reactive Protein/analysis ; Cytokines/blood* ; Female ; HLA-DR Antigens/immunology ; Human ; Interleukins/blood ; Lymphocyte Transformation ; Male ; Middle Age ; Monocyte Chemoattractant Protein-1/blood ; Monocytes/metabolism* ; RNA, Messenger/metabolism ; T-Lymphocytes/metabolism* ; Transforming Growth Factor beta/analysis ; Tumor Necrosis Factor/analysis

OBJECTIVETo investigate the effect of immune response mediated by antigen (oxidized low density lipoprotein, oxLDL)-specific T cells on plaque stability in coronary heart disease.

METHODSTwenty patients with acute myocardial infarction (AMI), 34 with unstable angina pectoris (UAP), 27 with stable angina pectoris (SAP) and 22 control subjects were enrolled in this study. MTS/PMS colorimetric assay was used to measure the proliferative response of the T cells to stimulation to 5 microg/ml oxLDL and detect IFN-gamma concentration produced in the proliferative response. The effect of C-reactive protein (CRP) on the proliferative response of the T cells to oxLDL and IFN-gamma concentration produced was examined in AMI group and UAP group.

RESULTSThe proliferative response of T cells to stimulation to 5 microg/ml oxLDL was significantly higher in AMI group and UAP group than in SAP group and the control group (P<0.05). IFN-gamma concentration produced in the proliferative response of the T cells was also significantly higher in AMI group and UAP group than in the other two groups (P<0.05). CRP at 10 microg/ml significantly increased the proliferative response of the T cells to oxLDL and IFN-gamma production in ACS group (P<0.001).

CONCLUSIONThe immune response mediated by the antigen-specific T cells, especially that mediated by type 1 T helper cells secreting IFN-gamma, may play an important role in the instability of plaques, and CRP may promote the inflammation of atherosclerosis through the effects on the specific immune response to oxLDL.

Aged ; Angina Pectoris ; immunology ; metabolism ; pathology ; Angina, Unstable ; immunology ; metabolism ; pathology ; C-Reactive Protein ; metabolism ; Case-Control Studies ; Coronary Disease ; immunology ; metabolism ; pathology ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; immunology ; metabolism ; pathology ; Plaque, Atherosclerotic ; immunology ; metabolism ; pathology ; T-Lymphocytes ; metabolism

OBJECTIVETo explore the protective effect and the mechanism of Puerarin Injection (PI) on myocardial ischemia reperfusion in patients with coronary heart disease (CHD) and angina pectoris (AP).

METHODSSeventy-eight patients with AP planned to receive the PTCA and stenting treatment were randomly divided and single-blindedly into the conventional group and the PI group. Based on the conventional treatment and pre-operational preparation, the PI group was given 200 ml of PI by intravenous dripping once a day, beginning from one week before operation, but to the conventional group, normal saline was given for instead. The condition of AP attack in balloon dilatatory stage of PTCA was observed and change of ST segment of ECG detected by a 12-lead ECG monitor. The blood levels of von Willebrand factor (vWF:Ag), nitric oxide (NO) and endothelin-1 (ET-1) were also observed before and after treatment.

RESULTSAs compared with those in the conventional group, number of patients having AP attack and ST segment change in PTCA process was lessened in the PI group, with blood levels of vWF:Ag and ET-1 obviously lower, and NO content obviously higher than those in the conventional group,

CONCLUSIONSPI could protect the myocardium in 2-3 days after ischemia reperfusion, one of the possible reasons is that PI can simulate the late phase of ischemic preconditioning, which may be related to its effect in lowering plasma vWF:Ag and ET-1, and increasing the serum NO content.

Angina Pectoris ; therapy ; Angioplasty, Balloon, Coronary ; Antigens ; blood ; Endothelin-1 ; blood ; Female ; Humans ; Infusions, Intravenous ; Isoflavones ; therapeutic use ; Male ; Middle Aged ; Myocardial Reperfusion Injury ; prevention & control ; Nitric Oxide ; blood ; Stents ; von Willebrand Factor ; immunology