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

Jiyu Zhang1, Fen Yang1, Yuhan Liao1

  • 1Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Engineering Research Center for Immunological Diagnosis and Therapy of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Biological Targeted Therapy, Huazhong University of Science and Technology, Ministry of Education, Wuhan, China.

JACC. Basic to Translational Science
|June 25, 2025
PubMed

Insights

Patients with unstable angina and high-sensitivity C-reactive protein (hsCRP) show sustained monocyte trained immunity. This heightened inflammation contributes to recurrent cardiovascular events despite secondary prevention efforts.

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.

Keywords:
hsCRPinflammatory riskmonocytetrained immunityunstable angina

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