The effect of some drugs on in vitro cellular immune reactions and on circulating immune complexes in patients with myocardial infarction.

The immunomodulatory effect of the lipid-reducing etofibrate, the calcium antagonist nifedipine and the immunosuppressive cyclosporine A was studied on in vitro cellular immune response in the presence of human aortic extract and of human LDL in 56 patients with acute myocardial infarction. 50 sex- and age-matched healthy persons were used as controls. Leukocyte migration test, level of C1q and of immune complexes and serum lipid parameters were measured. Leukocyte migration inhibition was observed against aorta in 68%, against LDL in only 23% of patients, which were significantly reduced by etofibrate and nifedipine and a similar, but not significant tendency was found using cyclosporine A against aorta. Leukocyte migration stimulation was observed in 9.0% and in 27% of patients against aorta and LDL, respectively. They were also considerably decreased by etofibrate and nifedipine. A high level of circulating immune complexes was found in hyperlipemic younger patients together with lower migration inhibition against LDL, which may be explained by authors' hypothesis: LDL is a component of circulating immune complexes, so there are few free LDL for lymphokines in the circulation. A correlation between specific (anti-aorta, anti-LDL) and nonspecific (PHA) immune responses was also detected in patients. The use of these drugs may be useful in the therapy of patients with myocardial infarction in order to modulate cellular immune reactions against vascular wall and LDL.