Enhanced Trained Immunity in Peripheral Monocytes in Unstable Angina With Elevated High-Sensitivity C-Reactive...

Area of Science:

• Immunology
• Cardiovascular Medicine
• Metabolic Health

Background:

• Recurrent cardiovascular events persist despite secondary prevention.
• Elevated high-sensitivity C-reactive protein (hsCRP) signifies increased inflammation and cardiovascular risk.
• Unstable angina (UA) is a critical manifestation of coronary heart disease.

Purpose of the Study:

• To investigate trained immunity in circulating monocytes of unstable angina (UA) patients.
• To determine if elevated hsCRP levels correlate with specific monocyte immune profiles.
• To understand the role of monocyte trained immunity in residual inflammation in cardiovascular disease.

Main Methods:

• Analysis of CD14+ monocytes from UA patients categorized by hsCRP levels (high-risk ≥3 mg/L vs. low-risk <1 mg/L).
• Assessment of cytokine production, metabolic activity, and transcriptional and epigenetic profiles of monocytes.
• Comparative analysis between high-risk and low-risk UA patient groups.

Main Results:

• Monocytes from UA patients with elevated hsCRP demonstrated enhanced proinflammatory responses.
• Elevated hsCRP was associated with increased glycolytic activity in monocytes.
• Significant alterations in immune cell profiles, indicative of sustained trained immunity, were observed in high-risk patients.

Conclusions:

• Elevated hsCRP in UA patients is linked to sustained monocyte trained immunity.
• This trained immunity contributes to persistent inflammation and residual risk in cardiovascular disease.
• Targeting monocyte-driven inflammation may offer new avenues for secondary prevention.