Preference toward a T-helper type 1 response in patients with coronary spastic angina

[摘要] Background - Coronary artery spasm plays an important role in the pathogenesis of ischemic heart diseases such as unstable angina (UA) and acute myocardial infarction. Nitric oxide ( NO) plays an important role in coronary artery spasm. We previously reported a deficiency in NO activity in the spasm arteries of patients with coronary spastic angina (CSA). Others have reported that NO influences the immune response. Therefore, we investigated the balance between T-helper type 1 (Th1) and 2 (Th2) responses in patients with CSA by evaluating the frequencies of interferon (IFN)-gamma- producing T cells and interleukin (IL)-4-producing T cells in the peripheral blood of such patients. Methods and Results - Peripheral blood mononuclear cells were collected from 50 consecutive patients with CSA, 23 consecutive patients with UA, 36 patients with stable angina ( SA), and 21 patients with chest pain syndrome (CPS). Cytokine-producing CD4+ T cells were quantified by 3-color flow cytometry after stimulation with phorbol myristate acetate and ionomycin. UA and CSA were associated with a significant increase in the frequency of CD4+ T cells that produced IFN-gamma, whereas these conditions caused no significant difference in the frequency of CD4+ T cells that produced IL-4. Culturing with an NO donor compound for 24 hours before stimulation inhibited the increase in the frequency of CD4+ T cells that produced IFN-gamma. Conclusions - We demonstrated that there was a preference toward the Th1-type response in patients with CSA and that T cells showed a reduced Th1-type response after being treated with NO.

[关键词] INTERCELLULAR-ADHESION MOLECULE-1;C-REACTIVE PROTEIN;UNSTABLE ANGINA;MYOCARDIAL-INFARCTION;INTERFERON-GAMMA;PLAQUE INFLAMMATION;IMMUNE-RESPONSE;ELEVATED LEVELS;ARTERY SPASM;MAST-CELLS