Proteoglycans in human atherosclerotic lesions--a pilot qualitative and quantitative study by ruthenium red

A pilot study was carried out to test whether normal human aorta and aortic atherosclerotic lesions obtained at post-mortem examination were suitable for the demonstration of proteoglycans (PGs) by ruthenium red (RR) staining, and whether by this method qualitative and quantitative differences of PGs might be detectable in various types of lesions and between lesions and the normal aortic intima. The results indicate that the PGs of the above tissues obtained at post mortem were clearly visualized by electron microscopy using the RR-indicator and were thus suitable for quantitative and qualitative evaluation. Of the RR-positive granules only those 20 nm and larger were assessed. RR-granules measuring 20-50 nm were present in normal intima and media, in increased concentration in the innermost part of the mixed fatty-gelatinous lesion, and in a decreased concentration in the fibrous cap of an atherosclerotic plaque. The same RR-granules were observed in a fatty streak and in addition 50-100 nm granules were present in this type of lesion; the overall RR-granule-concentration was reduced here. Granules of both sizes were interconnected by filamentous network. The differential presence of the large (and hitherto unreported) as well as the smaller granules in the various lesions is briefly discussed in the light of the present-day knowledge of tissue-PGs, and the importance of an examination in situ of the compound PGs-complexes in their native form, is emphasized.