Abstract
BackgroundType 2 diabetes is an important risk factor for the development of coronary artery disease (CAD). Focal or diffuse inflammation is often present in the vessels of patients with CAD. Mast cells are frequently present in the plaques as well as in the inflammatory infiltrates in the atherosclerotic vessel wall. In the study we wanted to examine whether there are differences in the morphology, number and distribution of mast cells and in their ability to modify the atherosclerotic process in coronary arteries (CA) in the diabetic vs. the hypertensive population of patients with CAD.MethodsCoronary artery endarterectomy specimens were obtained from patients with diabetes or hypertension as the only risk factor for CAD. The specimens were stained with haematoxylin-eosin and Sulphated Alcian Blue for mast cells and with immunofluorescent methods for fibrinogen-fibrin and IgG deposits in the vessel wall. Both morphological and stereological assessments were conducted for mast cells and mononuclear cell infiltrates.ResultsThe histological analysis of the vessel wall of diabetic patients in comparison with hypertensive patients showed a damaged endothelial cells layer and deposits of fibrin-fibrinogen and IgG in the tunica intima and media. The stereological count revealed a diminished numerical density of mast cells and a significantly higher volume density of the mononuclear cells. Mast cells displayed cytoplasmic vacuolization, extracellular extrusion of granule and pyknotic nuclei.ConclusionThis preliminary study suggests that the impaired mast cells might be the reason for more extensive inflammatory and immunologic atherosclerotic changes in the CA vessel wall of CAD patients with type 2 diabetes.Trial registration134/88;C3-0564-381-92
Highlights
Type 2 diabetes is an important risk factor for the development of coronary artery disease (CAD)
Patients had no statistically significant difference in body mass index (BMI), total cholesterol, low density lipoproteins (LDL) cholesterol and triglycerides, and in the incidence of cigarette smoking, whereas the difference in the high density lipoproteins (HDL) cholesterol level was of borderline significance
A lower numerical density of mast cells (Nvm) was demonstrated in diabetic patients in comparison with non-diabetic patients with arterial hypertension (Figure 3). In this preliminary study we demonstrated a clear difference in atherosclerotic lesions in CAD patients with type 2 diabetes in comparison with the patients from the hypertensive group
Summary
Type 2 diabetes is an important risk factor for the development of coronary artery disease (CAD). Coronary artery disease (CAD) can be macroscopically visible as one or more localized atherosclerotic plaques, or as a diffuse, long, concentric thickness of the vessel wall, which protrudes and obstructs the vessel lumen. These changes alter the structure of the vessel wall, disrupting normal cardiac function. It was reported that [17] mast cells may influence the course of the atherosclerotic process by releasing cytokines from their secretory granules and by coordinating the transportation of inflammatory cells in the vessel wall
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