Clinical significance of monocyte-derived dendritic cell activation in patients with acute coronary syndrome

Background: Acute coronary syndrome (ACS) is an amplified state of inflammation and immune reaction. Dendritic cells (DCs) expressing various Toll-like receptors (TLRs) have been observed in atherosclerotic lesions, however, the clinical significance of DCs in pathogenesis of ACS has not been completely investigated. Methods: Ten patients with ACS and 10 patients with stable angina pectoris (SAP) were enrolled in this study. Monocyte-derived DCs were generated from CD14 cells by culturing with granulocyte macrophage colony-stimulating factor and interleukin (IL)-4 for 6 days. Expression of cell surface CD86 and CD83 were measured by flowcytometry. Expression of genes, including CD86, CD83, CCL19, CCR7, TLR2, TLR4, TLR5, TLR8, and TLR9, were measured by real-time PCR. Plasma IL-6 and tumor necrosis factor (TNF)- levels were also measured. Results: The number of CD86CD83DCs in the ACS group was significantly higher than that in the SAP group (P < 0.05). Expression levels of CD86, CD83, CCL19, CCR7, TLR2, TLR4, and TLR9 in the ACS group were significantly higher than those in the SAP group (all, P < 0.05). Plasma IL-6 and TNF- levels in the ACS group were significantly higher than those in the SAP group (all, P < 0.05). In addition, a positive correlation was observed between the number of CD86CD83 cells and plasma levels of IL-6 (r = 0.88, P < 0.0001) as well as between the number of CD86CD83 cells TNF- levels (r = 0.78, P < 0.0001). Conclusions: These results demonstrated that monocyte-derived DCs are activated in patients with ACS, suggesting that activated DCs may play an important role in the pathogenesis of ACS.