Original article / research
A Histopathological Study of Mast Cells in Atheromatous Lesions on Autopsy Specimens
Dr. Priya Patil,
T 32, Sampige Road, Sadashiv Nagar, Belgaum, Karnataka, India.
Introduction: Atherosclerosis is emerging as one of the leading causes of death globally. Role of mast cells in the development and progression of atherosclerosis has been proposed recently. Literature review has shown that few studies have demonstrated significant number of mast cells in atherosclerotic plaques and more at the site of plaque rupture. Whereas, few studies have not found any significant increase in number of mast cells in atherosclerotic plaques. The present study was undertaken to know whether mast cells are significantly increased in atherosclerotic lesions.
Aim: The aim of the study was to know the correlation between mast cells and various grades of atherosclerosis.
Materials and Methods: A cross-sectional histopathological study was conducted on 60 autopsy heart specimens (perinatal and paediatric heart specimens were excluded) from October 2010 to October 2012 in Department of Pathology, Bangalore Medical College & Research Institute. Sections were taken from the Right Coronary Artery (RCA) and Left Coronary Artery (LCA) and its branches, aorta and pulmonary artery and were examined under the microscope for atheromatous lesions. American Heart Association (AHA) grading of atherosclerosis was used to grade atherosclerosis. Special stains for mast cells, 2% aqueous toluidine blue stain was employed on the sections to demonstrate and quantify mast cells (per mm2) in the arterial intima. The corresponding grade and number of mast cells were correlated.
Results: Of the total 360 arteries (includes all 6 arteries in each of the 60 cases) studied, 206 arteries showed atherosclerotic change. The most common artery involved was left anterior descending artery (in 57 cases i.e., 95%) followed by the left main coronary artery (in 48 cases i.e., 80%). Involvement of triple vessels (20 cases i.e., 33.3%) was most common, followed by four vessel involvement (18 cases i.e., 30%). Grade II (52 arteries i.e., 25.2%) atherosclerosis was most common, followed by grade IV (41 arteries i.e., 19.90%). Kruskal Wallis test showed significant difference in the median mast cells in various grades of atherosclerosis (p-value <0.05). Spearman’s correlation co-efficient showed positive correlation between various grades and number of mast cells in most of the arteries (except Left Circumflex Artery (LCxA) showed negative correlation and no statistical data could be derived for pulmonary artery as only 3/60 arteries showed atherosclerosis).
Conclusions: The present study has demonstrated that mast cells are found in good number in atherosclerotic lesions of coronary arteries and also with the progression of atherosclerosis, the number of mast cells increased except in the LCxA. Identifying the cellular participants and molecular mediators of inflammation during atherogenesis may prove to be of immense help in the treatment of coronary heart diseases.
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