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Updated: Jun 17, 2025
Quantification of Monocyte Transmigration and Foam Cell Formation from Individuals with Chronic Inflammatory Conditions
Published on: October 17, 2017
Circulating monocyte populations as biomarker for abdominal aortic aneurysms: a single-center retrospective cohort
Johannes Klopf1, Branislav Zagrapan1, Annika Brandau1
1Division of Vascular Surgery, Department of General Surgery, University Hospital Vienna, Medical University of Vienna, Vienna, Austria.
Background:
Abdominal aortic aneurysm (AAA) development is driven by inflammation, in particular myeloid cells, which represent attractive biomarker candidates. Yet to date, the maximum aortic diameter is the only clinically applied predictor of AAA progression and indicator for surgical repair. We postulated that aortic inflammation is reflected in a systemic change of monocyte populations, which we investigated regarding marker potential in AAA diagnosis and prognosis.
Methods:
We conducted a single-center retrospective cohort study in a diagnostic setting, measuring monocyte subsets by flow cytometry in peripheral blood samples of 47 AAA patients under surveillance, matched with 25 healthy controls and 25 patients with peripheral artery disease (PAD). In a prognostic setting, we acquired longitudinal data of 60 AAA patients including aneurysm growth assessment by computed tomography at 6-month intervals.
Results:
Blood levels of total monocytes, CD16+ monocytes and particularly intermediate monocytes were significantly increased in AAA patients versus healthy individuals and were also elevated compared to PAD patients. The combination of intermediate monocyte and D-dimer blood levels outperformed the individual diagnostic marker values. Additionally, the elevated concentrations of total monocytes, intermediate monocytes, and monocyte-platelet aggregates (MPA) were suited to predict rapid AAA progression over short-term periods of six months. Of note, MPA were identified as independent predictor of AAA disease progression in multivariable analysis.
Conclusion:
Circulating monocyte subsets are elevated in AAA patients and support diagnosis and prediction of aneurysm progression. Monocyte subsets and D-dimer reflect different hallmarks (inflammation and hemostasis) of AAA pathology and when combined, may serve as improved biomarker.
Insights
Blood levels of intermediate monocytes and monocyte-platelet aggregates (MPA) can help diagnose abdominal aortic aneurysm (AAA) and predict its rapid progression. Combining these with D-dimer may improve diagnostic accuracy.
Area of Science:
- Cardiovascular Biology
- Immunology
- Biomarker Discovery
Background:
- Abdominal aortic aneurysm (AAA) pathogenesis is linked to inflammation, particularly myeloid cell involvement.
- Current clinical practice relies on maximum aortic diameter for AAA progression prediction and surgical intervention decisions.
- Systemic changes in monocyte populations may reflect aortic inflammation and serve as potential biomarkers for AAA diagnosis and prognosis.
Purpose of the Study:
- To investigate the potential of circulating monocyte subsets as diagnostic and prognostic biomarkers for abdominal aortic aneurysm (AAA).
- To explore the relationship between monocyte populations and AAA progression.
- To evaluate the combined diagnostic and prognostic value of monocyte subsets with D-dimer.
Main Methods:
- A retrospective cohort study involving 47 AAA patients, 25 healthy controls, and 25 peripheral artery disease (PAD) patients.
- Monocyte subsets were quantified using flow cytometry in peripheral blood samples.
- Longitudinal data from 60 AAA patients were analyzed for aneurysm growth using computed tomography at 6-month intervals.
Main Results:
- Significantly elevated levels of total monocytes, CD16+ monocytes, and intermediate monocytes were observed in AAA patients compared to healthy controls and PAD patients.
- A combination of intermediate monocytes and D-dimer levels demonstrated superior diagnostic performance compared to individual markers.
- Elevated total monocytes, intermediate monocytes, and monocyte-platelet aggregates (MPA) predicted rapid AAA progression within six months.
- MPA were identified as an independent predictor of AAA disease progression in multivariable analysis.
Conclusions:
- Circulating monocyte subsets are elevated in AAA patients, aiding in diagnosis and predicting aneurysm progression.
- Monocyte subsets and D-dimer represent distinct AAA pathological features (inflammation and hemostasis), respectively.
- Combining monocyte subsets and D-dimer may offer improved biomarker potential for AAA management.
