Ozaki Yuichi, Imanishi Toshio, Hosokawa Seiki, Nishiguchi Tsuyoshi, Taruya Akira, Tanimoto Takashi, Kuroi Akio, Yamano Takashi, Matsuo Yoshiki, Ino Yasushi, Kitabata Hironori, Kubo Takashi, Tanaka Atsushi, Akasaka Takashi
Department of Cardiovascular Medicine, Wakayama Medical University.
Department of Cardiovascular Medicine, Hidaka General Hospital.
Circ J. 2017 May 25;81(6):837-845. doi: 10.1253/circj.CJ-16-0688. Epub 2017 Mar 24.
Although Toll-like receptor 4 (TLR-4) is involved in monocyte activation in patients with accelerated forms of atherosclerosis, the relationship between the expression of TLR-4 on circulating monocytes and coronary plaque vulnerability has not previously been evaluated. We investigated this relationship using 64-slice multidetector computed tomography (MDCT) in patients with stable angina pectoris (SAP).
We enrolled 65 patients with SAP who underwent MDCT. Three monocyte subsets (CD14CD16, CD14CD16, and CD14CD16) and expression of TLR-4 were measured by flow cytometry. Intracoronary plaques were assessed by 64-slice MDCT. We defined vulnerability of intracoronary plaques according to the presence of positive remodeling (remodeling index >1.05) and/or low CT attenuation (<35 HU). The circulating CD14CD16monocytes more frequently expressed TLR-4 than CD14CD16and CD14CD16monocytes (P<0.001). The relative proportion of the expression of TLR-4 on CD14CD16monocytes was significantly greater in patients with vulnerable plaque compared with those without (10.4 [4.1-14.5] % vs. 4.5 [2.8-7.8] %, P=0.012). In addition, the relative proportion of TLR-4 expression on CD14CD16monocytes positively correlated with the remodeling index (r=0.28, P=0.025) and negatively correlated with CT attenuation value (r=-0.31, P=0.013).
Upregulation of TLR-4 on CD14CD16monocytes might be associated with coronary plaque vulnerability in patients with SAP.
尽管Toll样受体4（TLR - 4）参与了动脉粥样硬化加速形式患者的单核细胞活化，但循环单核细胞上TLR - 4的表达与冠状动脉斑块易损性之间的关系此前尚未得到评估。我们使用64层多排螺旋计算机断层扫描（MDCT）对稳定型心绞痛（SAP）患者进行了此项关系的研究。
我们纳入了65例接受MDCT检查的SAP患者。通过流式细胞术检测三个单核细胞亚群（CD14CD16⁺、CD14CD16⁻和CD14CD16⁻）以及TLR - 4的表达。通过64层MDCT评估冠状动脉内斑块。我们根据阳性重构（重构指数>1.05）和/或低CT衰减（<35 HU）的存在来定义冠状动脉内斑块的易损性。循环中的CD14CD16⁺单核细胞比CD14CD16⁻和CD14CD16⁻单核细胞更频繁地表达TLR - 4（P<0.001）。与无易损斑块的患者相比，有易损斑块的患者中CD14CD16⁺单核细胞上TLR - 4表达的相对比例显著更高（10.4 [4.1 - 14.5]%对4.5 [2.8 - 7.8]%，P = 0.012）。此外，CD14CD16⁺单核细胞上TLR - 4表达的相对比例与重构指数呈正相关（r = 0.28，P = 0.025），与CT衰减值呈负相关（r = -0.31，P = 0.013）。
CD14CD16⁺单核细胞上TLR - 4的上调可能与SAP患者的冠状动脉斑块易损性有关。
