on December 8, 2005
Published online before print December 8, 2005, doi: 10.1161/01.ATV.0000199393.74656.4c
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Submitted on June 30, 2005
Accepted on November 16, 2005
Phenotypic Modulation of Intima and Media Smooth Muscle Cells in Fatal Cases of Coronary Artery Lesion
Hiroyuki Hao ;
From the Department of Pathology and Immunology (G.G., M.B., M.-L.B.-P.), University of Geneva-CMU, Geneva, Switzerland; Department of Pathology (H.H.), Hyogo Medical University, Hyogo, Japan; Division of Cardiology (E.C.), University Hospital Geneva, Geneva, Switzerland; CVPath (R.V.), International Registry of Pathology, Gaithersburg, Md.
* To whom correspondence should be addressed. E-mail: Marie-Luce.Piallat{at}medecine.unige.ch.
Objectives--Characterize the phenotypic features of media and intima coronary artery smooth muscle cells (SMCs) in mildly stenotic plaques, erosions, stable plaques, and in-stent restenosis.
Methods and Results--Expression of 
-smooth muscle actin (-SMA), smooth muscle myosin heavy chains (SMMHCs), and smoothelin was investigated by immunohistochemistry followed by morphometric quantification. The cross-sectional area and the expression of cytoskeletal proteins in the media were lower in restenotic lesions and, to a lesser extent, in stable plaques compared with mildly stenotic plaques and erosions. An important expression of -SMA was detected in the intima of the different lesions; moreover, -SMA staining was significantly larger in erosions compared with all other conditions. In the same location, a striking decrease of SMMHCs and a disappearance of smoothelin were observed in all situations.
Conclusions--Medial atrophy is prevalent in restenotic lesions and stable plaques compared with mildly stenotic plaques and erosions. Intimal SMCs of all situations exhibit a phenotypic profile, suggesting that they have modulated into myofibroblasts (MFs). The high accumulation of -SMA-positive MFs in erosions compared with stable plaques correlates with the higher appearance of thrombotic complications in this situation.
Key words:
-smooth muscle actin •
erosion •
smooth muscle myosin heavy chains •
smoothelin •
stable plaque
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