Immunological mechanisms in pathogenesis of coronary atherosclerosis

摘要

AIM: To evaluate functional parameters of immune system in patients with different variants of ischemic heart disease (IHD): stable angina pectoris and myocardial infarction; the role of immunological disorders in pathogenesis of IHD. MATERIAL AND METHODS: Immunological investigation of 136 IHD patients (102 with stable angina and 34 with myocardial infarction) included the study of the phenotype of lymphocytes: CD3, CD4, CD8, CD16, CD19, CD11/18, CD25, CD95 and HLA-DR. Measurements were made of serum concentrations of IL-1beta, IL-2, IL-6, IL-8, TNF-alpha, rIL-2 and expression of mRNA IL-1beta, IL-2, IL-6, TGFb1 in vascular wall of patients with coronary atherosclerosis (angina pectoris, myocardial infarction). RESULTS: One of the basic mechanisms taking part in development of atherosclerosis is immune-mediated inflammation of the vascular wall. Inflammatory cytokines have a significant role in this process. The serum levels of IL-1beta, IL-2, IL-6, IL-8, TNF-alpha in patients with coronary atherosclerosis were found to be significantly higher than in healthy controls. The study of IL-1beta, IL-2, IL-6, TGFb1 in tissue revealed that radial artery wall contains mRNA of the cytokines. The main cytokine of the aorta appeared to be IL-2, and the main peripheral artery cytokines were IL-1beta, IL-6. CONCLUSION: Increased serum concentrations of IL-1beta, IL-2, IL-8 in patients with coronary atherosclerosis reflect immune-inflammatory nature of the disease. Detection of dissimilar cytokines in tissue sampling reflects not only different degree of vascular involvement in the process but also phase evolution of the disease. Coronary atherosclerosis may result in adaptive immune response.