Circulating cells: the biofactory for markers of atherosclerotic disease

Abstract

Atherosclerotic cardiovascular disease remains the number one killer of the ageing population in Western society. The natural history of the disease is unknown, and clinical events may strike without any warning. There have long been efforts to discover new biomarkers and to validate surrogate end-points to diagnose patients at risk for acute manifestations of atherosclerotic disease and to test treatment efficacy. There is increasing evidence that suggests cross-talk between the diseased vascular tree and subsets of circulating cells. Functional, molecular, and structural characteristics of circulating cells may serve as biomarkers for initiation and progression of atherosclerotic disease. Several groups reported that the interleukin-6 (IL-6) release of circulating monocytes following in vitro lipopolysaccharide stimulation is strongly increased in patients suffering from unstable coronary syndromes compared with stable patients.1 Animal studies demonstrated altered peritoneal macrophage function after myocardial infarction which was restored during endurance training. This demonstrates that these functional tests could also serve as a surrogate measure of disease progression or regression.2 It has also been demonstrated that leucocyte Toll-like receptor responsiveness decreases acutely following vascular injury and increases chronically in relation to myocardial ischaemia.3 Although these studies identify the circulating cell as a promising target in the field of biomarker discovery, the search for circulating cell-related biomarkers is still in its infancy due to the lack of cohort studies with systematic storage of fractions of circulating cells. … *Corresponding author. Tel: +31 302507155, Fax: +31 302522693, Email: g.pasterkamp{at}hli.azu.nl