Pathophysiology of calcium deposition in coronary arteries.

BACKGROUND AND MORPHOLOGIC STUDIES: Because coronary artery calcification correlates highly with plaque burden, it is an excellent disease marker for atherosclerosis. However, it is not a sensitive indicator of disease activity, and does not predict luminal compromise because of compensatory remodeling. In addition, most data do not support the concept that plaque calcification is related to plaque instability. Plaques demonstrating acute rupture usually show mild or moderate calcification, and biophysical models do not predict that calcium should result in an increased propensity to rupture. This review outlines morphologic studies relating calcification to risk factors and coronary plaque morphology.

Healed plaque ruptures and sudden coronary death: evidence that subclinical rupture has a role in plaque progression.

BACKGROUND: Subclinical episodes of plaque disruption followed by healing are considered a mechanism of increased plaque burden. Detailed pathological studies of healed ruptures, however, are lacking. METHODS AND RESULTS: We identified acute and healed ruptures from 142 men who died of sudden coronary death and performed morphometric measurements of plaque burden, luminal stenosis, and smooth muscle cell phenotype. Healed ruptures were found in 61% of hearts and were associated with healed myocardial infarction, increased heart weight, dyslipidemia, and diabetes. Multiple healed rupture sites with layering were frequently found in segments with acute and healed rupture; the percent area luminal narrowing increased with increased numbers of healed sites of previous rupture. The underlying percent luminal narrowing for acute ruptures (mean 79+/-15%) exceeded that for healed ruptures (mean 66+/-14%, P:=0.0001), and the area within the internal elastic lamina was significantly less in healed ruptures than in acute ruptures, when segments were grouped by distance from the ostium. Healed ruptures favored the accumulation of immature smooth muscle cells at repair sites, with a cellular proliferation index of 0.40+/-0.09%, significantly higher than the index at the sites of rupture (P:=0.008). CONCLUSIONS: These data provide evidence that silent plaque rupture is a form of wound healing that results in increased percent stenosis. Healed ruptures occur in arteries with less cross-sectional area luminal narrowing than acute ruptures and are a frequent finding in men who die suddenly with severe coronary atherosclerosis.

Site-directed deletion mutagenesis using phagemid vectors and genetic selection.

Oligonucleotide-directed mutagenesis was used along with the dut and ung genetic selection method of Kunkel to introduce large site-specific deletions into cDNAs cloned into phagemid vectors. We find that large deletions can be achieved with an efficiency equal to that of single point mutations, with a very low frequency of aberrent clones. To facilitate screening of clones, E. coli strain DH5 alpha was used as the recipient host cell to genetically select for deletion mutants. Comparisons were made to deletion mutagenesis without genetic selection, and to reactions utilizing two oligonucleotide primers simultaneously. The low frequency of deletion mutants observed without genetic selection renders random screening for deletion mutant clones cumbersome. The results provide representative expectations and a useful guide for those contemplating the construction of deletion mutants.

Gene for parathyroid hormone-like peptide is on rat chromosome 2.

Parathyroid hormone-like peptide (PLP) is thought to be a mediator of hypercalcemia in both human and rodent malignancies. A rat PLP cDNA was used as a hybridization probe in Southern blot analysis of DNAs isolated from a panel of rat-mouse somatic cell hybrids. The single-copy gene for PLP was assigned to rat chromosome 2, whereas the rat parathyroid hormone (PTH) gene has previously been assigned to rat chromosome 1. Consequently, despite significant amino-terminal homology between PLP and PTH the genes encoding these peptides in the rat as well as human species have discrete chromosomal localizations.