Lymphocyte subpopulations in lymph nodes and peripheral blood: a comparison between patients with stable angina and acute coronary syndrome

• Published in: PloS one Vol. 7; no. 3; p. e32691
• Main Authors: Backteman, Karin, Andersson, Carina, Dahlin, Lars-Göran, Ernerudh, Jan, Jonasson, Lena
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.03.2012; Public Library of Science (PLoS)
• Subjects: Acute Coronary Syndrome - blood; Acute coronary syndromes; Aged; Aged, 80 and over; Analysis; Angina; Angina pectoris; Angina, Stable - blood; Antibodies; Antibodies - chemistry; Apoptosis; Arteriosclerosis; Atherosclerosis; Atherosclerosis - blood; Biology; Blood; Blood tests; Cardiology; Cardiomyopathy; Cardiovascular disease; CD16 antigen; CD19 antigen; CD25 antigen; CD3 antigen; CD4 antigen; CD69 antigen; CD8 antigen; CD8-Positive T-Lymphocytes - cytology; Cell Separation; Cloning; Coronary artery; Coronary artery disease; Coronary Artery Disease - blood; Coronary vessels; Councils; Cytometry; Female; Flow cytometry; Flow Cytometry - methods; Foxp3 protein; Health sciences; Heart attacks; Heart diseases; Histocompatibility antigen HLA; Humans; Immune response; Immune status; Immune System; Immunology; Immunoregulation; Immunosuppressive Agents - therapeutic use; Inflammation; Inflammatory response; Interleukin 18; Interleukin 18 receptors; Killer Cells, Natural - cytology; Laboratories; Lymph; Lymph nodes; Lymph Nodes - metabolism; Lymph Nodes - pathology; Lymphatic system; Lymphocyte Subsets - cytology; Lymphocytes; Lymphocytes - cytology; Lymphocytes B; Lymphocytes T; Male; Medical research; MEDICIN; MEDICINE; Middle Aged; Natural killer cells; Oxidative stress; Patients; Sarcoidosis; Stability; Stability analysis; Stem cells; Subpopulations; Surgery; T cell receptors; Thoracic surgery; Thorax; Transplants & implants
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0032691

Atherosclerosis is characterized by a chronic inflammatory response involving activated T cells and impairment of natural killer (NK) cells. An increased T cell activity has been associated with plaque instability and risk of acute cardiac events. Lymphocyte analyses in blood are widely used to evaluate the immune status. However, peripheral blood contains only a minor proportion of lymphocytes. In this study, we hypothesized that thoracic lymph nodes from patients with stable angina (SA) and acute coronary syndrome (ACS) might add information to peripheral blood analyses. Peripheral blood and lymph nodes were collected during coronary by-pass surgery in 13 patients with SA and 13 patients with ACS. Lymphocyte subpopulations were assessed by flow cytometry using antibodies against CD3, CD4, CD8, CD19, CD16/56, CD25, Foxp3, CD69, HLA-DR, IL-18 receptor (R) and CCR4. Lymph nodes revealed a lymphocyte subpopulation profile substantially differing from that in blood including a higher proportion of B cells, lower proportions of CD8(+) T cells and NK cells and a 2-fold higher CD4/CD8 ratio. CD4(+)CD69(+) cells as well as Foxp3(+) regulatory T cells were markedly enriched in lymph nodes (p<0.001) while T helper 1-like (CD4(+)IL-18R+) cells were more frequent in blood (p<0.001). The only significant differences between ACS and SA patients involved NK cells that were reduced in the ACS group. However, despite being reduced, the NK cell fraction in ACS patients contained a significantly higher proportion of IL-18R(+) cells compared with SA patients (p<0.05). There were several differences in lymphocyte subpopulations between blood and lymph nodes. However, the lymphocyte perturbations in peripheral blood of ACS patients compared with SA patients were not mirrored in lymph nodes. The findings indicate that lymph node analyses in multivessel coronary artery disease may not reveal any major changes in the immune response that are not detectable in blood.