Cellular immunostaining of angiotensin-converting enzyme in human coronary atherosclerotic plaques

Flavio Ribichini, Francesco Pugno, Valeria Ferrero, Gianni Bussolati, Mauro Feola, Paolo Russo, Carlo Di Mario, Antonio Colombo, Corrado Vassanelli

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES: The aim of this study was to determine the cellular localization of angiotensin I-converting enzyme (ACE) in the atherosclerotic plaque and its correlation with inflammation and cellular proliferation. BACKGROUND: Angiotensin I-converting enzyme inhibitors reduce the incidence of vascular events; therefore, tissue ACE may play a determinant role in the pathophysiology of the atherosclerotic plaque. METHODS: Histology and immunocytochemistry of de novo coronary plaques retrieved with directional coronary atherectomy from 141 patients were analyzed: 87 with stable angina, 39 with subacute unstable angina, and 15 with acute unstable angina. RESULTS: Compared with stable patients, unstable patients showed more thrombotic lesions (72% vs. 27%, p <0.0001), smaller areas of fibrous plaque (2.3 ± 1.2 mm2 vs. 2.8 ± 1.1 mm2, p = 0.02), higher cellular proliferative score (0.78 ± 0.9 vs. 0.27 ± 0.6, p = 0.003), larger content of ACE-stained cells (26.3 ± 23% vs. 12.6 ± 15%, p = 0.005) and larger areas of inflammation as identified by CD68 immunostaining (29.5 ± 22% vs. 20.2 ± 19%, p = 0.02). A significant linear correlation was found between CD68- and ACE-stained areas (mm2) among unstable patients (r = 0.6, p = 0.0001), but it was absent among stable patients (r = 0.006, p = 0.9). Co-localization of ACE, CD68, and alpha-actin was confirmed by double immunostaining. Patients with Ki-67-positive staining as an index of cell proliferation showed also significantly larger areas of ACE immunoactivity (p = 0.004). CONCLUSIONS: Our data demonstrate ACE immunoactivity in inflammatory and proliferative cells of coronary atherosclerotic plaques. In particular, patients with unstable angina showed larger areas of ACE immunoactive tissue and proliferating cells compared with stable patients. These observations support a role of the enzyme in the pathophysiology of coronary unstable plaques and suggest potentially different effects of ACE inhibitors according to clinical presentation.

Original languageEnglish
Pages (from-to)1143-1149
Number of pages7
JournalJournal of the American College of Cardiology
Volume47
Issue number6
DOIs
Publication statusPublished - Mar 21 2006

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Peptidyl-Dipeptidase A
Atherosclerotic Plaques
Unstable Angina
Angiotensin-Converting Enzyme Inhibitors
Cell Proliferation
Coronary Atherectomy
Inflammation
Stable Angina
Blood Vessels
Actins
Histology
Immunohistochemistry
Staining and Labeling
Incidence
Enzymes

ASJC Scopus subject areas

  • Nursing(all)

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Ribichini, F., Pugno, F., Ferrero, V., Bussolati, G., Feola, M., Russo, P., ... Vassanelli, C. (2006). Cellular immunostaining of angiotensin-converting enzyme in human coronary atherosclerotic plaques. Journal of the American College of Cardiology, 47(6), 1143-1149. https://doi.org/10.1016/j.jacc.2005.12.022

Cellular immunostaining of angiotensin-converting enzyme in human coronary atherosclerotic plaques. / Ribichini, Flavio; Pugno, Francesco; Ferrero, Valeria; Bussolati, Gianni; Feola, Mauro; Russo, Paolo; Di Mario, Carlo; Colombo, Antonio; Vassanelli, Corrado.

In: Journal of the American College of Cardiology, Vol. 47, No. 6, 21.03.2006, p. 1143-1149.

Research output: Contribution to journalArticle

Ribichini, F, Pugno, F, Ferrero, V, Bussolati, G, Feola, M, Russo, P, Di Mario, C, Colombo, A & Vassanelli, C 2006, 'Cellular immunostaining of angiotensin-converting enzyme in human coronary atherosclerotic plaques', Journal of the American College of Cardiology, vol. 47, no. 6, pp. 1143-1149. https://doi.org/10.1016/j.jacc.2005.12.022
Ribichini, Flavio ; Pugno, Francesco ; Ferrero, Valeria ; Bussolati, Gianni ; Feola, Mauro ; Russo, Paolo ; Di Mario, Carlo ; Colombo, Antonio ; Vassanelli, Corrado. / Cellular immunostaining of angiotensin-converting enzyme in human coronary atherosclerotic plaques. In: Journal of the American College of Cardiology. 2006 ; Vol. 47, No. 6. pp. 1143-1149.
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abstract = "OBJECTIVES: The aim of this study was to determine the cellular localization of angiotensin I-converting enzyme (ACE) in the atherosclerotic plaque and its correlation with inflammation and cellular proliferation. BACKGROUND: Angiotensin I-converting enzyme inhibitors reduce the incidence of vascular events; therefore, tissue ACE may play a determinant role in the pathophysiology of the atherosclerotic plaque. METHODS: Histology and immunocytochemistry of de novo coronary plaques retrieved with directional coronary atherectomy from 141 patients were analyzed: 87 with stable angina, 39 with subacute unstable angina, and 15 with acute unstable angina. RESULTS: Compared with stable patients, unstable patients showed more thrombotic lesions (72{\%} vs. 27{\%}, p <0.0001), smaller areas of fibrous plaque (2.3 ± 1.2 mm2 vs. 2.8 ± 1.1 mm2, p = 0.02), higher cellular proliferative score (0.78 ± 0.9 vs. 0.27 ± 0.6, p = 0.003), larger content of ACE-stained cells (26.3 ± 23{\%} vs. 12.6 ± 15{\%}, p = 0.005) and larger areas of inflammation as identified by CD68 immunostaining (29.5 ± 22{\%} vs. 20.2 ± 19{\%}, p = 0.02). A significant linear correlation was found between CD68- and ACE-stained areas (mm2) among unstable patients (r = 0.6, p = 0.0001), but it was absent among stable patients (r = 0.006, p = 0.9). Co-localization of ACE, CD68, and alpha-actin was confirmed by double immunostaining. Patients with Ki-67-positive staining as an index of cell proliferation showed also significantly larger areas of ACE immunoactivity (p = 0.004). CONCLUSIONS: Our data demonstrate ACE immunoactivity in inflammatory and proliferative cells of coronary atherosclerotic plaques. In particular, patients with unstable angina showed larger areas of ACE immunoactive tissue and proliferating cells compared with stable patients. These observations support a role of the enzyme in the pathophysiology of coronary unstable plaques and suggest potentially different effects of ACE inhibitors according to clinical presentation.",
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T1 - Cellular immunostaining of angiotensin-converting enzyme in human coronary atherosclerotic plaques

AU - Ribichini, Flavio

AU - Pugno, Francesco

AU - Ferrero, Valeria

AU - Bussolati, Gianni

AU - Feola, Mauro

AU - Russo, Paolo

AU - Di Mario, Carlo

AU - Colombo, Antonio

AU - Vassanelli, Corrado

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Y1 - 2006/3/21

N2 - OBJECTIVES: The aim of this study was to determine the cellular localization of angiotensin I-converting enzyme (ACE) in the atherosclerotic plaque and its correlation with inflammation and cellular proliferation. BACKGROUND: Angiotensin I-converting enzyme inhibitors reduce the incidence of vascular events; therefore, tissue ACE may play a determinant role in the pathophysiology of the atherosclerotic plaque. METHODS: Histology and immunocytochemistry of de novo coronary plaques retrieved with directional coronary atherectomy from 141 patients were analyzed: 87 with stable angina, 39 with subacute unstable angina, and 15 with acute unstable angina. RESULTS: Compared with stable patients, unstable patients showed more thrombotic lesions (72% vs. 27%, p <0.0001), smaller areas of fibrous plaque (2.3 ± 1.2 mm2 vs. 2.8 ± 1.1 mm2, p = 0.02), higher cellular proliferative score (0.78 ± 0.9 vs. 0.27 ± 0.6, p = 0.003), larger content of ACE-stained cells (26.3 ± 23% vs. 12.6 ± 15%, p = 0.005) and larger areas of inflammation as identified by CD68 immunostaining (29.5 ± 22% vs. 20.2 ± 19%, p = 0.02). A significant linear correlation was found between CD68- and ACE-stained areas (mm2) among unstable patients (r = 0.6, p = 0.0001), but it was absent among stable patients (r = 0.006, p = 0.9). Co-localization of ACE, CD68, and alpha-actin was confirmed by double immunostaining. Patients with Ki-67-positive staining as an index of cell proliferation showed also significantly larger areas of ACE immunoactivity (p = 0.004). CONCLUSIONS: Our data demonstrate ACE immunoactivity in inflammatory and proliferative cells of coronary atherosclerotic plaques. In particular, patients with unstable angina showed larger areas of ACE immunoactive tissue and proliferating cells compared with stable patients. These observations support a role of the enzyme in the pathophysiology of coronary unstable plaques and suggest potentially different effects of ACE inhibitors according to clinical presentation.

AB - OBJECTIVES: The aim of this study was to determine the cellular localization of angiotensin I-converting enzyme (ACE) in the atherosclerotic plaque and its correlation with inflammation and cellular proliferation. BACKGROUND: Angiotensin I-converting enzyme inhibitors reduce the incidence of vascular events; therefore, tissue ACE may play a determinant role in the pathophysiology of the atherosclerotic plaque. METHODS: Histology and immunocytochemistry of de novo coronary plaques retrieved with directional coronary atherectomy from 141 patients were analyzed: 87 with stable angina, 39 with subacute unstable angina, and 15 with acute unstable angina. RESULTS: Compared with stable patients, unstable patients showed more thrombotic lesions (72% vs. 27%, p <0.0001), smaller areas of fibrous plaque (2.3 ± 1.2 mm2 vs. 2.8 ± 1.1 mm2, p = 0.02), higher cellular proliferative score (0.78 ± 0.9 vs. 0.27 ± 0.6, p = 0.003), larger content of ACE-stained cells (26.3 ± 23% vs. 12.6 ± 15%, p = 0.005) and larger areas of inflammation as identified by CD68 immunostaining (29.5 ± 22% vs. 20.2 ± 19%, p = 0.02). A significant linear correlation was found between CD68- and ACE-stained areas (mm2) among unstable patients (r = 0.6, p = 0.0001), but it was absent among stable patients (r = 0.006, p = 0.9). Co-localization of ACE, CD68, and alpha-actin was confirmed by double immunostaining. Patients with Ki-67-positive staining as an index of cell proliferation showed also significantly larger areas of ACE immunoactivity (p = 0.004). CONCLUSIONS: Our data demonstrate ACE immunoactivity in inflammatory and proliferative cells of coronary atherosclerotic plaques. In particular, patients with unstable angina showed larger areas of ACE immunoactive tissue and proliferating cells compared with stable patients. These observations support a role of the enzyme in the pathophysiology of coronary unstable plaques and suggest potentially different effects of ACE inhibitors according to clinical presentation.

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