ABSTRACT
Risk factors for atherosclerosis may contribute to chronic low-grade inflammation. A highly cytotoxic and inflammatory CD4(+) cell subset (CD4(+)CD28(null) cells) has been associated with inflammatory diseases, including acute coronary syndromes (ACS). The aim of this study was to quantify and characterize CD4(+)CD28(null) cells in individuals with risk factors for atherosclerosis and patients with coronary artery disease (CAD). In order to achieve this goal, peripheral blood mononuclear cells (PBMCs) from individuals with risk factors for atherosclerosis and patients with CAD were analyzed using flow cytometry to detect cytotoxic molecules and evaluate the expression of homing receptors and inflammatory cytokines in CD4(+) cell subsets. The cells were evaluated ex vivo and after stimulation in culture. We found no differences in the proportions of CD4(+)CD28(null) cells among the groups. Compared with the CD4(+)CD28(+) population, the ex vivo CD4(+)CD28(null) subset from all groups expressed higher levels of granzymes A and B, perforin, granulysin and interferon-γ (IFN-γ). Individuals with risk factors and patients with ACS showed the highest levels of cytotoxic molecules. After stimulation, tumor necrosis factor-α (TNF-α) expression in the CD4(+)CD28(null) subset from these groups increased more than in the other groups. Stimulation with LPS decreased the expression of cytotoxic molecules by CD4(+)CD28(null) cells in all groups. In conclusion, our results show that risk factors for atherosclerosis may alter the CD4(+)CD28(null) cells phenotype, increasing their cytotoxic potential. Our findings also suggest that CD4(+)CD28(null) cells may participate in the early phases of atherosclerosis.
Subject(s)
Atherosclerosis/immunology , CD28 Antigens/metabolism , CD4-Positive T-Lymphocytes/metabolism , Coronary Artery Disease/immunology , T-Lymphocyte Subsets/metabolism , Adult , Aged , Aged, 80 and over , Antigens, Differentiation, T-Lymphocyte/biosynthesis , CD4-Positive T-Lymphocytes/immunology , Female , Granzymes/biosynthesis , Humans , Interferon-gamma/biosynthesis , Leukocytes, Mononuclear/metabolism , Lipopolysaccharides/pharmacology , Male , Middle Aged , Perforin/biosynthesis , Receptors, CCR7/metabolism , Receptors, CXCR3/metabolism , Risk Factors , T-Lymphocyte Subsets/immunology , Tumor Necrosis Factor-alpha/pharmacologyABSTRACT
Congestive Heart Failure (CHF) has been cause of increasing concern in the world, face its progressive prevalence and incidence and its social and economic repercussion, pointing to the need of revision of the syndrome concept and adoption of measures to reduce its economical and social costs. The objective of this study is to contextualize the comprehension of the physiopathology and the treatment of CHF and the nursing interventions to patients with this syndrome.
Subject(s)
Heart Failure , Nurse's Role , Heart Failure/diagnosis , Heart Failure/drug therapy , Heart Failure/physiopathology , Humans , Patient Compliance , Quality of Life , SyndromeABSTRACT
Atualmente, a Insuficiência Cardíaca (IC) é causa de preocupação crescente em todo o mundo, frente a sua prevalência e incidência progressivas e sua repercussão socio-econômica, apontando para a necessidade de revisão do conceito da síndrome e de adoção de medidas para redução dos seus custos econômicos e sociais. Este artigo tem como finalidade contextualizar os avanços na compreensão da fisiopatologia e do tratamento da IC e a atuação de Enfermagem junto aos pacientes portadores desta síndrome.
