This Article Full Text Full Text (PDF) All Versions of this Article: 113/19/2272    most recent CIRCULATIONAHA.105.588533v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rizzello, V. Articles by Crea, F. Search for Related Content PubMed PubMed Citation Articles by Rizzello, V. Articles by Crea, F. Pubmed/NCBI databases Substance via MeSH Related Collections Acute coronary syndromes

(Circulation. 2006;113:2272-2277.)
© 2006 American Heart Association, Inc.

Coronary Heart Disease

Modulation of CD4⁺CD28^null T Lymphocytes by Tumor Necrosis Factor- Blockade in Patients With Unstable Angina

Vittoria Rizzello, MD; Giovanna Liuzzo, MD; Salvatore Brugaletta, MD; Antonio Rebuzzi, MD; Luigi M. Biasucci, MD; Filippo Crea, MD

From the Cardiology Department, Catholic University, Rome, Italy.

Correspondence to Dr Vittoria Rizzello, Cardiology Department, University Hospital "A. Gemelli," Catholic University, Largo "A. Gemelli" 8, 00168 Rome, Italy.

Received September 12, 2005; revision received March 7, 2006; accepted March 15, 2006.

Background— Tumor necrosis factor- (TNF-) is a proinflammatory cytokine that favors the expansion of CD4⁺CD28^null T cells, an aggressive and unusual proinflammatory lymphocyte subset frequently observed in patients with unstable angina (UA). The purpose of the present ex vivo study was to evaluate whether inflammation in patients with UA may be modulated by selective blockade of TNF-.

Methods and Results— Peripheral blood samples were collected from 17 patients with UA (Braunwald’s class IIIB). CD4⁺CD28^null T cells were assessed by flow cytometry and expressed as a percentage of all CD4⁺ T cells after 24 hours of incubation of whole blood with and without increasing doses (0.1, 1, 10, and 100 µg/mL) of infliximab, an anti–TNF- monoclonal antibody. In addition, CD28 expression was assessed and expressed as mean fluorescence intensity (geometric mean of the CD28 fluorescence value on all CD4⁺ T cells). CD4⁺CD28^null T-cell percentage decreased from a median of 6.2% (range, 1.2% to 23.9%) to 4.9% (range, 1.1% to 21.9%), 4.5% (range, 1.1% to 21.6%), and 4.1% (range, 0.4% to 21.4%) after incubation with 1, 10, and 100 µg/mL of infliximab (P for trend=0.043). Analysis of CD28 mean fluorescence intensity showed that the expression of CD28 on cell surface significantly increased after incubation with increasing doses of infliximab (P for trend=0.03).

Conclusions— The findings of this ex vivo study show that CD4⁺CD28^null T-cell expansion in patients with UA may be reduced by selective TNF- blockade. Further studies are warranted to evaluate the clinical benefit of CD4⁺CD28^null T-cell modulation.

---

 

CLINICAL PERSPECTIVE

This article has been cited by other articles:

				G. Liuzzo, L. M. Biasucci, G. Trotta, S. Brugaletta, M. Pinnelli, G. Digianuario, V. Rizzello, A. G. Rebuzzi, C. Rumi, A. Maseri, et al. Unusual CD4+CD28null T Lymphocytes and Recurrence of Acute Coronary Events J. Am. Coll. Cardiol., October 9, 2007; 50(15): 1450 - 1458. [Abstract] [Full Text] [PDF]

				P. Aukrust, A. Yndestad, W. J. Sandberg, L. Gullestad, and J. K. Damas T Cells in Coronary Artery Disease: Different Effects of Different T-Cell Subsets J. Am. Coll. Cardiol., October 9, 2007; 50(15): 1459 - 1461. [Full Text] [PDF]

				R. P. Giugliano and E. Braunwald The Year in Non ST-Segment Elevation Acute Coronary Syndrome J. Am. Coll. Cardiol., October 2, 2007; 50(14): 1386 - 1395. [Full Text] [PDF]

				B. Zal, C. Baboonian, and J. C. Kaski Letter to the Editor: Autoreactive CD4+CD28- T Cells and Acute Coronary Syndromes Arterioscler. Thromb. Vasc. Biol., March 1, 2007; 27(3): E18 - E18. [Full Text] [PDF]