In-situ analysis of mast cells and dendritic cells in coronary atherosclerosis in chronic kidney disease (CKD)
2018
Aims. Mast cells (MC) and dendritic cells
(DC) have immune modulatory function and can
influence T-cell activity. Both cell types have been found
in atherosclerotic plaques and are thought to play an
important role for plaque stability. Compared to matched
segments of the non-renal population, patients with
chronic kidney disease (CKD) show a more pronounced
and more aggressive course of atherosclerosis with
higher plaque calcification and significantly higher
complication rates. It was the aim of this study to
analyze the number and localization of MCs and DCs,
macrophages, T- and B-cells as well as the expression of
markers of inflammation such as CRP and NFκΒ in
calcified and non-calcified atherosclerotic plaques of
patients with CKD and control patients. Methods. Fifty
coronary atherosclerotic plaques from patients with
endstage CKD (CKD, n=25) and control (n=25) patients
were categorized according to the Stary classification
and investigated using immunohistochemistry (markers
for MC, DC, T, B, macrophage and NFκΒ). Expression
was analyzed separately for the complete plaque area as
well as for the different plaque subregions and
correlations were analyzed. Results. We found only very
few DCs and MCs per lesion area with slightly increased
numbers in calcified plaques. MCs per plaque area were
significantly more frequent in CKD than in control
patients and this was independent of plaque calcification.
MCs were most frequently found in the shoulder and
basis of the plaque. DCs per plaque area were
significantly less in calcified plaques of CKD compared
to control patients. In control, but not in CKD patients,
DCs were significantly more frequent in calcified than in
non-calcified plaques. Within the plaques, DCs were
similarly distributed between all 4 subregions.
Conclusions. Coronary atherosclerotic plaques of CKD
patients showed a significantly higher number of MCs
whereas DCs were less frequent compared to control
patients particularly if plaques were calcified. These
findings might indicate a potential proinflammatory role
of MCs, but not of DCs in atherosclerotic lesions of
CKD patients, adding another characteristic of advanced
atherosclerosis in these patients.
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