Sakurai S, Inoue A, Ohwa M, Koh C S, Ohkubo K, Hikita H, Kohno H, Yanagisawa N
Third Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto.
J Cardiol. 1995 Sep;26(3):139-47.
Chronic inflammatory cells are key components in the progression of atherosclerotic plaques and restenosis after coronary angioplasty. Adhesion molecules are fundamental in inflammatory processes. Therefore, the distributions of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule (VCAM) were investigated in directional coronary atherectomy specimens obtained from 14 patients, in 6 with acute coronary syndromes (myocardial infarction and unstable angina within 1 month), 6 with old myocardial infarction and 2 with stable effort angina. There were eight primary lesions and six restenotic lesions. Atherectomy tissue fragments were snap frozen and cut into 4 microns thick cryostat sections for immunohistochemical staining by avidin-biotin complex immunoperoxidase techniques using adhesion molecule specific monoclonal antibodies BBIG-I1 (ICAM-1) and BBIG-V1 (VCAM). The cells of lesions were characterized in sequential sections by macrophage marker KP1 (CD68), endothelial marker JC/70A (CD31), and smooth muscle cell marker 1A4 (alpha-smooth muscle actin). Four restenotic lesions that had undergone a prior balloon angioplasty within a few months consisted of intimal proliferation and the other lesions were atherosclerotic plaque. Macrophage-rich areas were seen in the lesions from acute coronary syndromes and/or early restenotic lesions. Expression of ICAM-1 or VCAM was strongly associated with macrophage-rich areas, but VCAM staining was weaker than ICAM-1 except in one restenotic lesion. Macrophages that express ICAM-1 and/or VCAM may be important in the unstable plaques and restenotic lesions related to disease activity of ischemic heart disease.
慢性炎症细胞是动脉粥样硬化斑块进展以及冠状动脉成形术后再狭窄的关键组成部分。黏附分子在炎症过程中起重要作用。因此，我们研究了从14例患者获取的定向冠状动脉斑块旋切标本中细胞间黏附分子-1（ICAM-1）和血管细胞黏附分子（VCAM）的分布情况，其中6例患有急性冠状动脉综合征（1个月内发生心肌梗死和不稳定型心绞痛），6例有陈旧性心肌梗死，2例有稳定型劳力性心绞痛。有8个原发性病变和6个再狭窄病变。将斑块旋切组织碎片速冻后切成4微米厚的冰冻切片，采用抗生物素蛋白-生物素复合物免疫过氧化物酶技术，使用黏附分子特异性单克隆抗体BBIG-I1（ICAM-1）和BBIG-V1（VCAM）进行免疫组织化学染色。在连续切片中，通过巨噬细胞标志物KP1（CD68）、内皮标志物JC/70A（CD31）和平滑肌细胞标志物1A4（α-平滑肌肌动蛋白）对病变细胞进行鉴定。4个在数月内曾接受过球囊血管成形术的再狭窄病变由内膜增生组成，其他病变为动脉粥样硬化斑块。在急性冠状动脉综合征和/或早期再狭窄病变的病变中可见富含巨噬细胞的区域。ICAM-1或VCAM的表达与富含巨噬细胞的区域密切相关，但除一个再狭窄病变外，VCAM染色比ICAM-1弱。表达ICAM-1和/或VCAM的巨噬细胞可能在与缺血性心脏病疾病活动相关的不稳定斑块和再狭窄病变中起重要作用。
