Apoptosis and Mobilization of Lymphocytes to Cardiac Tissue Is Associated with Myocardial Infarction in a Reperfused Porcine Model and Infarct Size in Post-PCI Patients.
Maria Josefa FortezaIsabel TraperoArantxa HervasElena de DiosAmparo Ruiz-SauriGema MinanaClara BonanadCristina GómezRicardo OltraCesar Rios-NavarroDaniel F J KetelhuthJulio NunezFrancisco J ChorroVicente BodiPublished in: Oxidative medicine and cellular longevity (2018)
ST-segment elevation myocardial infarction (STEMI) is the most severe outcome of coronary artery disease. Despite rapid reperfusion of the artery, acute irrigation of the cardiac tissue is associated with increased inflammation. While innate immune response in STEMI is well described, an in-depth characterization of adaptive immune cell dynamics and their potential role remains elusive. We performed a translational study using a controlled porcine reperfusion model of STEMI and the analysis of lymphocyte subsets in 116 STEMI patients undergoing percutaneous coronary intervention (PCI). In the animal model, a sharp drop in circulating T lymphocytes occurred within the first hours after reperfusion. Notably, increased apoptosis of circulating lymphocytes and infiltration of proinflammatory Th1 lymphocytes in the heart were observed 48 h after reperfusion. Similarly, in STEMI patients, a sharp drop in circulating T lymphocyte subsets occurred within the first 24 h post-PCI. A cardiac magnetic resonance (CMR) evaluation of these patients revealed an inverse association between 24 h circulating T lymphocyte numbers and infarction size at 1-week and 6-month post-PCI. Our translational approach revealed striking changes in the circulating and tissue-infiltrating T lymphocyte repertoire in response to ischemia-reperfusion. These findings may help in developing new diagnostic and therapeutic approaches for coronary diseases.
Keyphrases
- percutaneous coronary intervention
- st segment elevation myocardial infarction
- coronary artery disease
- acute myocardial infarction
- st elevation myocardial infarction
- acute coronary syndrome
- peripheral blood
- antiplatelet therapy
- coronary artery bypass grafting
- immune response
- newly diagnosed
- end stage renal disease
- magnetic resonance
- left ventricular
- ejection fraction
- oxidative stress
- chronic kidney disease
- coronary artery bypass
- type diabetes
- patients undergoing
- heart failure
- cardiovascular events
- cerebral ischemia
- acute ischemic stroke
- prognostic factors
- coronary artery
- early onset
- liver failure
- computed tomography
- signaling pathway
- endoplasmic reticulum stress
- hepatitis b virus
- magnetic resonance imaging
- aortic stenosis
- subarachnoid hemorrhage
- toll like receptor
- brain injury
- peritoneal dialysis
- dendritic cells
- patient reported