Posted on Nov 25, 2019, 4 p.m.
Most people know that plaque buildup is a precursor for heart disease, but many are not sure what can be done to target the condition; a new study published in Nature Medicine suggests targeted therapy designed to prevent heart attacks and strokes for those who are at increased risk.
Researchers from Icahn School of Medicine at Mount Sinai have identified a specific immune cell found in arterial plaque in patients who had recently suffered a stroke or a mini-stroke; findings have also been presented at the Vascular Discovery Scientific Session.
"Despite decades of research, we don't know how to predict and prevent plaque from rupturing in the arteries," said Chiara Giannarelli, M.D., Ph.D. “Most of the research has involved looking at human tissue under the microscope,” said senior author Giannarelli. “Little is known about how and which individual cell types contribute the most to ruptures causing [a] stroke or heart attack.”
38 patients with an average age of 72 who had undergone carotid endarterectomy to remove plaque from their arteries were included in this study, at the time some reported experiencing no symptoms and others reported either a stroke or mini-stroke within the past 6 months. Plaque tissue was analyzed using mass cytometry techniques to determine basic cellular make up from 15 patients, and findings were expanded in a second mass cytometry analysis with the remaining 23 patients, as well as gene expression being analyzed in all individual immune cells in plaque to study function.
“We found an unexpected dominance of T-cells in this plaque,” explained Dawn Fernandez, a distinguished professor at ISSMS and the lead author of the study. “These findings in the plaque were different and unrelated to T-cell levels found in the patients’ blood samples.”
T-cells play an important role in adaptive immunity, in this study they were found to have an unexpected role in increasing the risk factors for atherosclerosis. In particular they were found to be present in more advanced plaques and that the sub type CD4-positive effector memory cells were more common in those who had experienced a stroke.
"This analysis highlights that there is localized inflammation driven by T-cells in atherosclerotic plaque which is not related to any systemic immune response," said Giannarelli.
According to a study published in Seminars in Immunology CD4 T cells play a less defined role in immunity, making them challenging to study. The presence of T cells in plaque may suggest localized inflammation unrelated to any systemic immune response.
“This milestone study finally proved the inflammatory theory of heart disease,” Giannarelli said. “This may help us eventually identify targets for new immune therapies for the late stages of atherosclerosis.”
Maintain an active lifestyle and healthy diet could be a way to circumvent the condition as well as its deleterious complications if plaque buildup is a precursor to inflammation. Consuming more anti-inflammatory and antioxidant foods will not just help to reduce the risk of heart disease, they are also loaded with other nutrients that can help the entire body in a variety of ways.
Fatty fish are a good source of omega-3 fatty acids which are anti-inflammatory and they can also help reduce the risk of other chronic diseases such as diabetes and kidney disease. Cruciferous vegetables such as broccoli can help to reduce the risk of cancer and heart disease, it is rich in the antioxidant sulforaphane with potent anti-inflammatory properties. Peppers are loaded with vitamin C and other potent antioxidants to go along with their anti-inflammatory properties. Turmeric is a powerful anti-inflammatory agent, however the body doesn’t absorb it well making it advised to take with black pepper to boost absorption.
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This article is not intended to provide medical diagnosis, advice, treatment, or endorsement.