Plasma cells in the carotid plaque: occurrence and significance

G. Cerrone, D. Fanni, M.L. Lai, C. Gerosa, R. Cau, A. Balestrieri, G. Orrù, G. Senes, G. Faa, L. Saba

Division of Pathology, Department of Medical Sciences and Public Health, University of Cagliari, AOU of Cagliari, Cagliari, Italy. daniela.fanni@unica.it

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• Angiology

OBJECTIVE: Atherosclerosis is one of the leading causes of disability and mortality worldwide. Inflammation, including monocytes, T and B cells, plays a key role in its pathogenesis. Our purpose was to evaluate plasma cells’ presence in a large series of carotid artery plaques and the clinical association.

PATIENTS AND METHODS: Forty-eight consecutive patients treated with carotid endarterectomy were retrospectively analyzed to assess plasma cells’ presence inside the plaque. A semiquantitative grading score was applied, ranging from absence, scattered, clusters of 5-10, and sheets of >10 plasma cells. Plasma cell’s location, as intraplaque, subendothelial or peri-adventitial, was also defined.

RESULTS: In 75% of plaques analyzed, plasma cells were detected: scattered in 63.9%, in clusters in 22.2%, and in sheets in 13.9% of cases. In all cases, plasma cells were observed only inside the plaque. In 13.9% and in 11.1% of cases, plasma cells showed, respectively, a concomitant subendothelial or peri-adventitial distribution. In 5.6% of plaques, there was a simultaneous distribution in subendothelial, peri-adventitial layer, and intraplaque. Association between the presence of symptoms and plasma cells infiltrate was found.

CONCLUSIONS: Our results suggest that plasma cells could be a key parameter linked to plaque instability. Some types of configurations are significantly associated with the occurrence of cerebrovascular symptoms.

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