Department of Pathology University of Sao Paulo Medical School Sao Paulo Brazil.
Control and Automation Engineering Federal Institute of Education, Science and Technology of Sao Paulo Sao Paulo Brazil.
J Am Heart Assoc. 2022 Mar 15;11(6):e023274. doi: 10.1161/JAHA.121.023274. Epub 2022 Mar 1.
Background Inflammation of the perivascular adipose tissue (PvAT) may be related to atherosclerosis; however, the association of polarized macrophages in the pericoronary PvAT with measurements of atherosclerosis components in humans has not been fully investigated. Methods and Results Coronary arteries were dissected with surrounding PvAT. We evaluated the percentage of arterial obstruction, intima-media thickness, fibrous cap thickness, plaque components, and the number of vasa vasorum. The number of proinflammatory (M1) and anti-inflammatory (M2) macrophages in the periplaque and control PvAT were evaluated using immunohistochemistry. Regression models adjusted for sociodemographic and clinical variables were used. In 319 segments from 82 individuals, we found a correlation of the M1/M2 macrophage density ratio with an increase in arterial obstruction (=0.02) and lipid content (=0.01), and a decrease in smooth muscle cells (=0.02). M1 and the ratio of M1/M2 macrophages were associated with an increased risk of thrombosis (=0.03). In plaques with thrombosis, M1 macrophages were correlated with a decrease in fibrous cap thickness (=0.006), an increase in lipid content (=0.008), and the number of vasa vasorum in the adventitia layer (=0.001). M2 macrophages were correlated with increased arterial obstruction (=0.01), calcification (=0.02), necrosis (=0.03) only in plaques without thrombosis, and decrease of the number of vasa vasorum in plaques with thrombosis (=0.003). Conclusions M1 macrophages in the periplaque PvAT were associated with a higher risk of coronary thrombosis and were correlated with histological components of plaque progression and destabilization. M2 macrophages were correlated with plaque size, calcification, necrotic content, and a decrease in the number of vasa vasorum in the adventitia layer.
血管周围脂肪组织（PvAT）的炎症可能与动脉粥样硬化有关；然而，人类冠状动脉周围 PvAT 中极化巨噬细胞与动脉粥样硬化成分测量之间的关系尚未得到充分研究。
用周围的 PvAT 对冠状动脉进行解剖。我们评估了动脉阻塞的百分比、内膜-中膜厚度、纤维帽厚度、斑块成分和血管丛的数量。使用免疫组织化学评估斑块内和对照 PvAT 中促炎（M1）和抗炎（M2）巨噬细胞的数量。使用调整社会人口统计学和临床变量的回归模型。在 82 名个体的 319 个节段中，我们发现 M1/M2 巨噬细胞密度比与动脉阻塞增加（=0.02）和脂质含量增加（=0.01）相关，与平滑肌细胞减少（=0.02）相关。M1 和 M1/M2 巨噬细胞的比值与血栓形成的风险增加相关（=0.03）。在有血栓形成的斑块中，M1 巨噬细胞与纤维帽厚度减少（=0.006）、脂质含量增加（=0.008）和外膜层血管丛数量增加（=0.001）相关。M2 巨噬细胞与动脉阻塞增加（=0.01）、钙化（=0.02）、坏死（=0.03）相关，仅在无血栓形成的斑块中，与血栓形成斑块中血管丛数量减少（=0.003）相关。
斑块内 PvAT 中的 M1 巨噬细胞与冠状动脉血栓形成的风险增加相关，并与斑块进展和不稳定的组织学成分相关。M2 巨噬细胞与斑块大小、钙化、坏死含量以及外膜层血管丛数量减少相关。
