Human monocyte-derived macrophages: Pathogenetic role in plaque rupture associated to systemic inflammation

Francesco Fracassi, Giampaolo Niccoli, Nicola Cosentino, Sonia Eligini, Susanna Fiorelli, Franco Fabbiocchi, Vincenzo Vetrugno, Hesham Refaat, Rocco Antonio Montone, Giancarlo Marenzi, Elena Tremoli, Filippo Crea

Research output: Contribution to journalArticlepeer-review


Background: Macrophages play a key role in coronary plaque destabilization. In-vitro human monocyte-derived macrophages (MDMs) are used to study macrophages infiltrating tissue. Optical coherence tomography (OCT) provides an in-vivo insight of the coronary arteries. We compared the MDMs morpho-phenotype and culprit plaque features at OCT in acute coronary syndrome (ACS) patients according to the underlying plaque pathobiology. Methods: Sixty-six patients undergoing coronary angiography and pre-angioplasty OCT of the culprit vessel were allocated to three groups according to mechanism of ACS at OCT and C-reactive protein levels (cut-off: 2 mg/Ll): 1) plaque rupture with systemic inflammation; 2) plaque rupture without systemic inflammation, 3) plaque with intact fibrous cap. A blood sample was collected to obtain MDMs, categorized as having “round” or “spindle” morphology. Results: Thirty-two patients (48.5%) were assigned to Group 1, 10 (15.2%) to Group 2 and 24 (36.4%) to Group 3. The “round” MDMs were significantly more frequent in Group 1 (39.25 ± 4.98%) than in Group 2 (23.89 ± 3.10%) and Group 3 (23.02 ± 7.89%), p = 0.008. MDMs in Group 1 as compared to Groups 2 and 3 showed lower efferocytosis (8.74 ± 1.38 vs 9.74 ± 2.15 vs 11.41 ± 2.41; p = 0.012), higher tissue factor levels (369.84 ± 101.13 vs 301.89 ± 59.78 vs 231.74 ± 111.47; p = 0.001) and higher heme oxygenase-1 expression (678.78 ± 145.43 vs 419.12 ± 74.44 vs 409.78 ± 64.33; p = 0.008). Conclusions: MDMs of ACS patients show morpho-phenotypic heterogeneity with prevalence of pro-thrombotic and pro-oxidative properties in case of plaque rupture and systemic inflammation. Such MDMs subpopulation may take part to the cellular pathways leading to fibrous cap rupture with the subsequent thrombus formation.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalInternational Journal of Cardiology
Publication statusPublished - Feb 15 2021


  • Acute coronary syndrome
  • Coronary thrombosis
  • Inflammation
  • Monocyte-derived macrophages
  • Optical coherence tomography
  • Plaque rupture

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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