Deficiency of mast cells in coronary artery endarterectomy of male patients with type 2 diabetes

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

Mast Cells Might Have a Protective Role against the Development of Calcification and Hyalinisation in Severe Aortic Valve Stenosis

“…It is also known that osteopontin, a secretory product of mast cells and a potent inhibitor of ectopic calcification in intercellular valvular tissue, could prevent valvular tissue remodelling (Giachelli and Steitz, 2000;Steitz et al, 2002). Other studies suggested that diminished numerical density of impaired mast cells might be the reason for more extensive inflammatory and immunologic atherosclerotic changes in the vessel wall of coronary arteries in patients with coronary artery disease (Pleskovič et al, 2011), implicating that mast cells may play an important role in the protection of the integrity of endothelial cell layers and the vessel wall, probably via their paracrine activity, especially through the release of heparin (Pleskovič et al, 2011). The release of heparin as an anticoagulant substance, which leads to higher endogenous heparin levels and higher levels of IgE, may have the primary role in the protective function of vessel wall endothelial cells (Sinkiewicz, 2002).…”

“…After deparaffinization, the sections were stained with HE, with toluidine blue solution (Pleskovič et al, 2011), and Movat pentachrome method to identify mast cells, or they were used for immunohistochemistry methods to identify T cells and macrophages. Histological analysis was performed by a trained pathologist blind to the treatment protocols.…”

Common mechanisms underlying diabetic vascular complications: focus on the interaction of metabolic disorders, immuno-inflammation, and endothelial dysfunction

“…Numerous previous studies have focused on the role of mast cells (MCs) in AS and CHD. It has been found that MCs have involved in vascular plaque formation and inflammatory infiltration to atherosclerotic vessel walls through cell cytoplasmic vacuolization, extracellular extrusion of granules and nuclear sequestration [ 122 ]. MCs can secrete various mediators to activate other inflammatory cells (such as lymphocytes and foam cells) and affect the metabolism and circulation of HDL and LDL [ 123 , 124 ].…”