Sardella G, De Luca L, Francavilla V, Accapezzato D, Di Roma A, Gianoglio O, Colantonio R, Mancone M, Fedele F, Paroli M
Department of Cardiovascular and Respiratory Sciences, La Sapienza University, Rome, Italy.
Int J Immunopathol Pharmacol. 2007 Oct-Dec;20(4):791-9. doi: 10.1177/039463200702000415.
T lymphocytes play an important role in the induction and progression of acute coronary syndromes (ACS). To gain insight into how different T cell subsets can influence ACS, we analyzed the frequencies of circulating CD4+ T cells producing either pro-inflammatory interferon(IFN)-gamma or anti-inflammatory interleukin (IL)-10 in subjects presenting with ST-elevation myocardial infarction (STEMI). The effect of coronary bare metal (BS) and paclitaxel-eluting stent (PES) on the balance between CD4+IFN-gamma+ and CD4+IL-10+ lymphocytes was also investigated. Peripheral blood mononuclear cells (PBMC) were isolated from 38 consecutive patients with STEMI before and 48 hrs or 6 days after implantation of either BS or PES. Twenty patients with no history of coronary artery disease were included as basal controls. PBMC were stimulated in vitro with anti-CD3/anti-CD28 monoclonal antibodies, and CD4+IFN- gamma+ or CD4+IL-10+ T cells were detected by flow cytometry intracellular staining. The frequency of peripheral CD4+IL-10+ T cells was significantly higher in STEMI patients as compared with controls. Conversely, the frequency of CD4+IFN-gamma+ T lymphocytes did not differ between STEMI and subjects without history of coronary artery disease. Six days after the revascularization procedure, the percentage of CD4+IL-10+ T cells was significantly decreased in BS but not in the PES group, whereas the relative percentage of CD4+IFN-gamma+ T lymphocytes were diminished in both groups as compared with baseline levels. Our data indicate that STEMI is associated with a peripheral expansion of CD4+IL-10+ T lymphocytes, and that primary coronary revascularization with implantation of either BS or PES is followed by a reduction in circulating CD4+IFN-gamma+ T lymphocytes. PES implantation, however, appears to inhibit the relative decrease of the IL-10 producing lymphocyte as observed in BS implanted patients, shifting the balance between pro-inflammatory and anti-inflammatory T cell populations in favor of the latter.
T淋巴细胞在急性冠状动脉综合征（ACS）的诱发和进展过程中发挥着重要作用。为深入了解不同T细胞亚群如何影响ACS，我们分析了ST段抬高型心肌梗死（STEMI）患者中产生促炎性干扰素（IFN）-γ或抗炎性白细胞介素（IL）-10的循环CD4⁺T细胞的频率。同时还研究了冠状动脉裸金属支架（BS）和紫杉醇洗脱支架（PES）对CD4⁺IFN-γ⁺和CD4⁺IL-10⁺淋巴细胞之间平衡的影响。从38例连续性STEMI患者植入BS或PES之前以及植入后48小时或6天采集外周血单个核细胞（PBMC）。纳入20例无冠状动脉疾病史的患者作为基础对照。用抗CD3/抗CD28单克隆抗体在体外刺激PBMC，通过流式细胞术细胞内染色检测CD4⁺IFN-γ⁺或CD4⁺IL-10⁺T细胞。与对照组相比，STEMI患者外周血CD4⁺IL-10⁺T细胞的频率显著更高。相反，STEMI患者与无冠状动脉疾病史的受试者之间，CD4⁺IFN-γ⁺T淋巴细胞的频率没有差异。血运重建术后6天，BS组中CD4⁺IL-10⁺T细胞的百分比显著下降，而PES组未下降，然而，与基线水平相比，两组中CD4⁺IFN-γ⁺T淋巴细胞的相对百分比均降低。我们的数据表明，STEMI与CD4⁺IL-10⁺T淋巴细胞的外周扩增有关，并且植入BS或PES进行初次冠状动脉血运重建后，循环CD4⁺IFN-γ⁺T淋巴细胞会减少。然而，与植入BS的患者相比，植入PES似乎抑制了产生IL-10的淋巴细胞的相对减少，使促炎性和抗炎性T细胞群体之间的平衡向后者倾斜。
