Angiogenesis of atherosclerotic plaques in patients with metabolic syndrome

Abstract

Introduction: Numerous studies have demonstrated that endothelial damage is a precursory symptom o f atherosclerosis, which leads to an increase o f vascular permeability, activation o f mast cells and migration o f leukocytes, lymphocytes, macrophages, adhesion o f platelets, proliferation o f vascular smooth muscle cells and eventual vasospasm and pro-inflammatory condition. All o f the above listed components can be rightf-ully considered active pathogenetic participants in atherosclerosis and a result o f aggregation o f all risk factors that accompany a wide variety o f cardiovascular diseases, such as coronary heart disease, hypertension, diabetes, dyslipidemia, etc. The influx of monocytes and mast cells during the early stages of atherosclerosis leads to the most pronounced manifestations of vascular inflammation, especially in patients with metabolic disorders. Angiogenesis is a very important pathogenetic element of atherosclerosis in stages of complicated plaques, along with mast cells and macrophages. CD -105 is a sensitive marker of newly formed endothelial cells, an effective index of activation and proliferation of microvessels, not only in aggressive forms of cancer, but also in atherosclerotic plaques of the affected vessels. The plaque neovascularization process often begins in intima, progresses and leads to further destabilization of atherosclerotic plaques (intramural hemorrhage, ruptures etc.). Also, anti-MCT (mast cell tryptase) and CD-68 demonstrate clearly the important pathogenetic stages and patterns of atherosclerosis development and its complications in patients with metabolic disorders. Purpose and Objectives: In our study, we analyzed the histotopographic distribution of newly formed blood vessels as a feature of angiogenesis, the extent of mast cell degranulation, the expression of macrophages in different types of plaques, as well as various arterial vessels in patients with atherosclerosis and metabolic syndrome, complicated by atherosclerosis. We have tried to analyze the importance of mast cells and macrophages, the patterns of development of atherosclerosis stages, along with diagnostic and prognostic features. Materials and Methods: The study included 34 patients, who died of atherosclerosis (no. =17) and atherosclerotic complications of metabolic syndrome (no. =17). Fragments of their cerebral (middle cerebral arteries), carotid, coronary arteries, aorta (thoracic and abdominal segments), renal, iliac and vertebral arteries were collected for research at autopsy. The fragments were processed using standard techniques. The type definition of plaques was based on morphological classification, as well as on macroscopic and histological images of hematoxylin-eosin stained sections and on histochemical methods - silver and orcein impregnation. To determine the expression of mast cells in the affected vessels, we have used anti-M CT immunohistochemical stain. Macrophages were identified using the CD-68 specific marker and the newly formed vessels - respectively, by using C D -105 (Endoglin), which is specific. Results and conclusion: The evaluation of the results was based on determining the density and intensity of the final reaction, reflected in the quantitative ratio of different zones of atheromatous plaques. Positively stained mast cells, macrophages and newly formed vessels were found in many types of atherosclerotic plaques, especially in adventitia and in the immediate vicinity of plaques and in subendothelial layers. We found a statistical correlation between the plaque type and clinical data. The immunohistochemical method is effective for determining mast cells, macrophages, and newly formed vessels of atherosclerotic plaques, directly reflecting many important pathogenetic elements of atherogenesis in patients with metabolic syndrome. C D -105 is a valuable marker of angiogenesis o f atherosclerotic plaques, intimal arteries and adventitial vessels, an indicator of the degree of variation in the pathological development of atherosclerosis - the factors that may be important in introducing modem methods of research, diagnosis, treatment and prognosis of these diseases.