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Biological profile of monocyte-derived macrophages in coronary heart disease patients: implications for plaque

Sonia Eligini1, Nicola Cosentino2, Susanna Fiorelli2

  • 1Centro Cardiologico Monzino I.R.C.C.S., Milan, Italy. sonia.eligini@cardiologicomonzino.it.

Scientific Reports
|June 20, 2019
PubMed

Insights

Monocyte-derived macrophages (MDMs) from coronary artery disease (CAD) patients show distinct features, including a higher prevalence of round cells with pro-inflammatory and pro-thrombotic properties. This MDM profile aids in identifying high-risk CAD patients.

Area of Science:

  • Cardiovascular Biology
  • Immunology
  • Pathology

Background:

  • Macrophage phenotype within atherosclerotic plaques influences disease progression and stability.
  • Coronary plaque macrophages are inaccessible; monocyte-derived macrophages (MDMs) serve as a surrogate model.
  • Understanding MDM characteristics in coronary artery disease (CAD) is crucial for risk stratification.

Purpose of the Study:

  • To compare the phenotypic profile of MDMs from CAD patients versus healthy subjects.
  • To assess the association between CAD MDM profiles and in vivo coronary plaque characteristics using optical coherence tomography (OCT).
  • To determine if MDM profiles can identify CAD patients at high risk.

Main Methods:

  • Morphological analysis of MDMs from CAD patients and healthy controls.
  • Assessment of efferocytosis, transglutaminase-2, CD206, CD163, and tissue factor (TF) levels in MDMs.
  • Correlation of MDM profiles with in vivo coronary plaque features (lipid-rich plaque, thin-cap fibroatheroma, macrophage accumulation, plaque rupture) via OCT.

Main Results:

  • CAD patient MDMs exhibited a higher proportion of round cells compared to spindle cells, unlike in healthy subjects.
  • MDMs from CAD patients showed reduced efferocytosis, lower CD206/CD163 levels, and increased TF expression.
  • A higher prevalence of round MDMs correlated with lipid-rich plaques, thin-cap fibroatheroma, increased macrophage burden, and plaque rupture.
  • MDM efferocytosis correlated with minimal lumen area; TF levels correlated with ruptured plaque.

Conclusions:

  • MDMs from CAD patients display significant morpho-phenotypic heterogeneity, characterized by round cells with pro-inflammatory and pro-thrombotic traits.
  • The distinct MDM profile in CAD patients, particularly the prevalence of round cells, is linked to adverse plaque characteristics.
  • MDM phenotyping offers a potential tool for identifying high-risk individuals with CAD.

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