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Plasma cells in the carotid plaque: occurrence and significance
1Division of Pathology, Department of Medical Sciences and Public Health, University of Cagliari, AOU of Cagliari, Cagliari, Italy. daniela.fanni@unica.it.
Insights
Plasma cells are frequently found in carotid artery plaques and are associated with symptoms. Their presence and distribution may indicate plaque instability and cerebrovascular events.
Area of Science:
- Cardiovascular Research
- Immunology
- Pathology
Background:
- Atherosclerosis is a major global health concern, driven by inflammatory processes.
- Monocytes, T cells, and B cells are known contributors to atherosclerosis pathogenesis.
Purpose of the Study:
- To investigate the presence and distribution of plasma cells within carotid artery plaques.
- To determine the clinical association between plasma cell infiltration and patient symptoms.
Main Methods:
- Retrospective analysis of 48 carotid endarterectomy specimens.
- Semiquantitative grading of plasma cell presence (absent, scattered, clusters, sheets).
- Assessment of plasma cell location (intraplaque, subendothelial, peri-adventitial).
Main Results:
- Plasma cells were detected in 75% of analyzed plaques.
- Various infiltration patterns were observed, including scattered cells, clusters, and sheets.
- A significant association was found between plasma cell infiltration and the presence of cerebrovascular symptoms.
Conclusions:
- Plasma cells may serve as a critical marker for carotid plaque instability.
- Specific plasma cell configurations correlate with the occurrence of cerebrovascular events.
Objective:
Atherosclerosis is one of the leading causes of disability and mortality worldwide. Inflammation, including monocytes, T and B cells, plays a key role in its pathogenesis. Our purpose was to evaluate plasma cells' presence in a large series of carotid artery plaques and the clinical association.
Patients And Methods:
Forty-eight consecutive patients treated with carotid endarterectomy were retrospectively analyzed to assess plasma cells' presence inside the plaque. A semiquantitative grading score was applied, ranging from absence, scattered, clusters of 5-10, and sheets of >10 plasma cells. Plasma cell's location, as intraplaque, subendothelial or peri-adventitial, was also defined.
Results:
In 75% of plaques analyzed, plasma cells were detected: scattered in 63.9%, in clusters in 22.2%, and in sheets in 13.9% of cases. In all cases, plasma cells were observed only inside the plaque. In 13.9% and in 11.1% of cases, plasma cells showed, respectively, a concomitant subendothelial or peri-adventitial distribution. In 5.6% of plaques, there was a simultaneous distribution in subendothelial, peri-adventitial layer, and intraplaque. Association between the presence of symptoms and plasma cells infiltrate was found.
Conclusions:
Our results suggest that plasma cells could be a key parameter linked to plaque instability. Some types of configurations are significantly associated with the occurrence of cerebrovascular symptoms.
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