Athanassopoulos Petros, Balk Aggie H M M, Vaessen Leonard M B, Caliskan Kadir, Takkenberg Johanna J M, Weimar Willem, Bogers Ad J J C
Department of Cardiothoracic Surgery, Erasmus MC, Rotterdam, The Netherlands.
Int J Cardiol. 2009 Jan 9;131(2):246-56. doi: 10.1016/j.ijcard.2007.10.031. Epub 2008 Feb 19.
Dysregulation of dendritic cell (DC) mediated immune responses towards auto-antigens, is considered an important feature in the maintenance of experimentally induced heart failure (HF). In order to evaluate the role of blood DCs in cardiomyopathies of different origins, we examined myeloid (mDC) and plasmacytoid (pDC) subset levels and maturation characteristics, according to HF severity and etiology in humans.
Absolute numbers of mDCs and pDCs in 12 New York Heart Association (NYHA) class-II, 28 NYHA class III-IV HF patients and 18 healthy controls, were studied by 4-colour whole blood flow cytometry.
End-stage (NYHA III-IV) HF patients had comparable circulating DC subset levels to NYHA-II patients and controls. However, within the NYHA III-IV group total DC levels in patients with non-ischemic dilated cardiomyopathy (DCM) were higher (P<0.001) than in patients with coronary artery disease (CAD), hypertrophic cardiomyopathy (HCM) or other HF etiology. This was due to a significant increase of primarily mDCs (P<0.0001) and to a lesser extent of pDCs (P<0.05) in idiopathic DCM patients, independent of systolic or diastolic cardiac dysfunction. Maturation marker CD83 and lymphoid homing chemokine receptor CCR7 surface expression was enhanced only on mDCs, but not pDCs from DCM patients (P<0.05), compared to patients with CAD, HCM or other underlying cardiac pathophysiology.
Total blood DC levels in end-stage HF are elevated in patients with DCM. Whole blood DC characterisation may lead to new insights into the pathophysiology of idiopathic DCM in humans.
树突状细胞（DC）介导的针对自身抗原的免疫反应失调被认为是实验性诱导心力衰竭（HF）维持过程中的一个重要特征。为了评估血液DC在不同病因心肌病中的作用，我们根据人类HF的严重程度和病因，检测了髓样（mDC）和浆细胞样（pDC）亚群水平及成熟特征。
采用四色全血流式细胞术研究了12例纽约心脏协会（NYHA）心功能II级、28例NYHA心功能III-IV级HF患者及18例健康对照者体内mDC和pDC的绝对数量。
终末期（NYHA III-IV级）HF患者的循环DC亚群水平与NYHA-II级患者及对照者相当。然而，在NYHA III-IV级组中，非缺血性扩张型心肌病（DCM）患者的总DC水平高于冠心病（CAD）、肥厚型心肌病（HCM）或其他HF病因患者（P<0.001）。这是由于特发性DCM患者中主要是mDC显著增加（P<0.0001），pDC在较小程度上增加（P<0.05），且与收缩期或舒张期心功能不全无关。与CAD、HCM或其他潜在心脏病理生理患者相比，DCM患者的mDC上成熟标志物CD83和淋巴细胞归巢趋化因子受体CCR7的表面表达增强，但pDC上未增强（P<0.05）。
DCM患者终末期HF的全血DC水平升高。全血DC特征分析可能会为人类特发性DCM的病理生理学带来新的见解。
