Immunocytochemical analysis of the atherosclerotic lesion

We have performed immunocytochemical investigations on the distribution of various cell types and proliferating cells in human atherosclerotic lesions. Studies include fibrocellular tissue response following percutaneous transluminal coronary angioplasty (PTCA) or aortocoronary (A-C) bypass operation using monoclonal antibodies specific to smooth muscle cells, macrophages, endothelial cells, lymphocytes and proliferating cell nuclear antigen (PCNA). All studies were performed on methanol-Carnoy's-fixed, paraffin-embedded tissues. The cellular composition of the following three types of raised lesions were analyzed: 1) fibro-fatty lesions composed almost exclusively of macrophages; 2) fibrous lesions predominantly composed of smooth muscle cells; 3) advanced plaques characterized by complex layers of smooth muscle cells and macrophages with considerable variation from region to region. Also noted were foci of medial and even intimal vascularization subjacent to the more advanced plaques. Cells encountered within the fibrous intimal thickening in the vein graft or fibrocellular tissue response following PTCA were predominantly smooth muscle cells in origin. Some cells were PCNA-positive. These studies demonstrate the application of monoclonal antibody technology to the study of the cellular composition and cell kinetics of human atherosclerotic lesions.