| Objective: Atherosclerosis is considered as a chronic inflammatory process.By detecting the expression levels of inflammatory-related cells and proteins in the lesions of coronary atherosclerosis,we analyzed the relationship between inflammation and structural changes of lesions and sudden death of coronary heart disease,and explored the role of inflammation in the occurrence and development of human coronary atherosclerosis lesions and the relationship between inflammation and sudden death of coronary heart disease.Methods: Coronary artery atherosclerosis were confirmed by autopsy and histopathological examination in Forensic Judicial Appraisal Center of Guizhou Medical University.According to whether the cause of death is sudden death of coronary heart disease and whether it is accompanied by thrombosis,plaque rupture,plaque hemorrhage and other secondary changes,it is divided into three experimental groups(L1 group: sudden death of coronary heart disease but not of coronary heart disease;L2 group: sudden death of coronary heart disease without any of the secondary changes mentioned above;L3 group: sudden death of coronary heart disease with any of the secondary changes mentioned above).The control group had no lesion of coronary artery.The tissue structure of coronary artery were observed by routine hematoxylin-eosin staining on paraffin section.The image analysis software was used to measure the correlation of atherosclerotic plaque structure,and the number and quantity of inflammatory cells in the lesion were counted:CD45,CD68,CD19,NCAM.The detection of inflammation-related cells and factors by immunohistochemical staining,Western blotting and Quantitative Real-time PCR: ICAM-1,MCP-1 and TNF-?.The correlation between inflammatory response and structural changes of coronary atherosclerotic lesions and sudden coronary death was analyze.Results:(1)Compared with the control group,the experimental group had pathological changes such as thinning of the fibrous cap,thickening of the intima thickness,thickness of the necrotic foci,and decrease of the vessel area fraction(P<0.05);(2)The comparison of the number of white blood cells,B-lymphocytes,foam cells,and natural killers in coronary atherosclerotic lesions,the control group <L1 group <L2 group <L3 group,and the difference was statistically significant(P<0.05);(3)The expressions of CD45,CD68,CD19,ICAM-1,MCP-1 and TNF-? in coronary arteries showed an increasing trend in the control group,L1,L2 and L3 groups,and the difference was statistically significant(P<0.05);(4)The mRNA levels of the above proteins in the coronary arteries in the control group and the three experimental groups showed a statistically significant(P<0.05)increasing trend;(5)The expression of the above proteins in coronary lesions showed an increasing trend between the groups: the control group <L1 group <L2 group <L3 group,and the difference was statistically significant(P<0.05).And the positive expression sites are mainly distributed on the shoulders and bottom of the plaques with brown-yellow coloration;(6)The expression of NCAM protein in coronary tissue and lesions showed an increasing trend in the control group,L1 and L2 groups(P<0.05),and decreased in the L3 group.Conclusion: There are different degrees of infiltration of inflammatory cells and increased expression of inflammatory factors in coronary atherosclerotic lesions.The intensity of inflammatory response is related to changes in lesion structure;the degree of inflammatory reaction may affect the changes of lesion structure.Decreased plaque stability in the lesion is the main cause of secondary lesions,and is also the mechanism of sudden coronary death. |
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