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Letter to Editor

‘Hot stuff': inflammatory lymphocyte populations in acute coronary syndrome

Cellular & Molecular Immunology volume 12, pages 513–514 (2015)Cite this article

Acute myocardial infarction and coronary unstable plaque: definitely ‘hot stuff' to address. However, it is not just a pun. Atherosclerosis and acute coronary syndrome are both characterized by active inflammation.1 Increased levels of C-reactive protein and inflammatory cytokines have been found during the very early phases of acute myocardial infarction2 and are associated with a worse prognosis.1

The immune system also participates in almost every phase of atherosclerotic disease.3 There is increasing evidence that both adaptive and innate immunity tightly regulate atherogenesis. Adaptive immune populations, particularly T cells, regulate the magnitude of the pro-inflammatory atherogenic response. Immune-mediated processes are involved during the onset, development and rupture of coronary plaques, where the presence of activated T lymphocytes was demonstrated decades ago.4 CD4+, and to a lesser extent CD8+ T cells, localize in atherosclerotic plaques. T cells also influence the stability of the atherosclerotic lesion and thus the propensity for thrombus formation and the clinical outcome of disease. T-cell responses observed in patients with unstable angina are antigen-driven and directed against antigens contained in coronary atherosclerotic plaques.5 Patients with unstable angina are characterized by a perturbation of the functional T-cell repertoire with a bias toward interferon-gamma production, suggesting that monocyte activation and acute phase responses are consequences of T-cell activation.6 Interferon-gamma is produced by CD4+CD28null T cells, which are expanded in patients with unstable angina yet demonstrably low in patients with stable angina and controls. Several novel CD4+ T-cell subsets, including Th9 cells and Th17 cells, have recently been identified during the progression of coronary atherosclerosis.

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  1. FESC, Departement of Medical & Surgical Sciences, University of Foggia, Foggia, Italy

    Natale Daniele Brunetti

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Brunetti, N. ‘Hot stuff': inflammatory lymphocyte populations in acute coronary syndrome. Cell Mol Immunol 12, 513–514 (2015). https://doi.org/10.1038/cmi.2014.96

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