Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands.
Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands.
Atherosclerosis. 2021 May;325:69-74. doi: 10.1016/j.atherosclerosis.2021.03.040. Epub 2021 Apr 7.
We aimed to determine the association of circulatory markers of innate and adaptive immunity with carotid atherosclerotic plaque characteristics.
In 1602 participants from the population-based Rotterdam Study with subclinicalcarotid atherosclerosis, blood sampling was performed to determine granulocyte, platelet, monocyte (innate immunity) and lymphocyte (adaptive immunity) counts, from which the granulocyte-to-lymphocyte ratio [GLR], platelet-to-lymphocyte ratio [PLR], monocyte-to-lymphocyte ratio [MLR] and systemic immune-inflammation index [SII] were calculated. All participants underwent carotid MRI for evaluation of plaque characteristics. Plaque size (stenosis >30%, maximum plaque thickness) and plaque composition (presence of intraplaque hemorrhage [IPH], lipid-rich necrotic core [LRNC], and calcification) were assessed. Using linear and logistic regression models, the association of innate and adaptive immunity markers with plaque size and plaque components, adjusting for relevant confounders, was assessed.
Higher levels of granulocytes were significantly associated with larger plaque thickness (mean difference [Ln (mm)] per Ln increase granulocyte count [95% CI]: 0.06 [0.02; 0.10]). Conversely, more lymphocytes related with smaller maximum plaque thickness (mean difference [Ln (mm)] per Ln increase lymphocyte count: 0.09 [-0.14;-0.04]) and a lower prevalence of IPH (odds ratio per Ln increase lymphocyte count: 0.60 [0.37; 0.97]). Moreover, all ratio measures were associated with larger plaque thickness, of which the MLR also associated with more frequent LRNC (odds ratio per Ln increase MLR: 1.26 [1.02; 1.56]).
The innate immunity links to larger plaques, whilst the adaptive immunity seems to relate to smaller plaques and a lower frequency of IPH. These results suggest that an imbalance in innate and adaptive immunity may play a role in the vulnerability of carotid atherosclerotic plaques.
本研究旨在确定固有免疫和适应性免疫的循环标志物与颈动脉粥样硬化斑块特征之间的关联。
在基于人群的鹿特丹研究中，有 1602 名参与者存在亚临床颈动脉粥样硬化，对其进行了血液采样，以确定粒细胞、血小板、单核细胞（固有免疫）和淋巴细胞（适应性免疫）计数，并计算出粒细胞与淋巴细胞比值[GLR]、血小板与淋巴细胞比值[PLR]、单核细胞与淋巴细胞比值[MLR]和全身免疫炎症指数[SII]。所有参与者均接受颈动脉 MRI 检查以评估斑块特征。评估斑块大小（狭窄>30%，最大斑块厚度）和斑块成分（斑块内出血[IPH]、富含脂质的坏死核心[LRNC]和钙化的存在）。使用线性和逻辑回归模型，在调整相关混杂因素后，评估固有和适应性免疫标志物与斑块大小和斑块成分的关系。
粒细胞水平升高与更大的斑块厚度显著相关（每增加 Ln 粒细胞计数的 Ln（mm）差异[95%CI]：0.06 [0.02; 0.10]）。相反，更多的淋巴细胞与最大斑块厚度较小相关（每增加 Ln 淋巴细胞计数的 Ln（mm）差异：0.09 [-0.14;-0.04]）和 IPH 的发生率较低（每增加 Ln 淋巴细胞计数的比值比：0.60 [0.37; 0.97]）。此外，所有比值测量均与更大的斑块厚度相关，其中 MLR 也与更频繁的 LRNC 相关（每增加 Ln MLR 的比值比：1.26 [1.02; 1.56]）。
固有免疫与更大的斑块相关，而适应性免疫似乎与较小的斑块和较少发生 IPH 相关。这些结果表明，固有免疫和适应性免疫的失衡可能在颈动脉粥样硬化斑块的脆弱性中发挥作用。
