• Flavia del Porto, Maria Proietta, Luigi Tritapepe, Fabio Miraldi, Angela Koverech, Patrizia Cardelli, Fabio Tabacco, Vincenzo de Santis, Andrea Vecchione, Anna Paola Mitterhofer, Italo Nofroni, Rachele Amodeo, Massimo Trappolini, and Giuseppe Aliberti.
• Dipartimento di Medicina Clinica e Molecolare, II Facoltà di Medicina e Chirurgia, Università La Sapienza, Ospedale Sant'Andrea, Via di Grottarossa 1035-1039, Rome, Italy. flavia.delporto@uniroma1.it
• Ann. Med. 2010 Dec 1; 42 (8): 622629622-9.

ObjectiveThe aim of our study was to evaluate the lymphocyte subpopulations and the cytokines in the peripheral blood of patients with type-A Stanford acute aortic dissection (AAD group) and to determine whether inflammatory cells are present at the site of aortic dissection.MethodsThirty-five consecutive patients with type-A Stanford dissection were evaluated for haemochrome and lymphocyte subpopulations (CD3+, CD4+, CD8+, CD19+, CD4+CD25+, CD16+CD56+, CD4+CD28-, CD8+CD28-) by flow cytometry. C-reactive protein (CRP), tumour necrosis factor (TNF)-α, interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, interferon-gamma (IFN-γ), and monocyte chemoattractant protein (MCP)-1 were measured by ELISA. In addition, immunohistochemical staining with cell type-specific antibodies was performed to study the inflammatory cells detected inside the aortic wall.ResultsIn the AAD group, a significant increase in natural killer (NK) (P = 0.032), B cells (P = 0.022), and CD8+CD28- (P = 0.045) subpopulations was observed, whereas there was a significant decrease in total T lymphocytes (P = 0.004) and T helper fractions (P = 0.005). Moreover, a significant increase in CRP (P < 0.0001), IL-6 (P < 0.0001), IL-8 (P < 0.0001), IL-10 (P < 0.0001), TNF-α (P < 0.0001), and MCP-1 (P < 0.001) was observed; macrophages represented the main population detected inside the media.ConclusionsOur results strongly support the hypothesis of a pivotal role of innate immunity in type-A Stanford AAD.

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