Dynamics of the innate immune response profile in patients with coronary heart disease at different times after coronary artery stenting

Introduction. Atherosclerosis is accompanied by damage to the vascular endothelium of the arteries, where an inflammatory response develops and an atherosclerotic plaque forms. And an important component here is innate immunity, which is the key and earliest non-specific mechanism.Оbjective: a comprehensive assessment of the cellular link of innate immunity, and comparison of the results obtained at various times after coronary stenting.Materials and Methods: The study involved 50 patients with coronary atherosclerosis (Group 1), who are indicated for stenting of the coronary arteries and 20 volunteers (Group 2), who have no signs of coronary artery disease. The study of immunity parameters was carried out before surgery, after 4-5, 9-10 and 28-30 days, which was the early postoperative period, as well as 6 and 12 months after stenting, i.e. in the late postoperative period. Phenotyping of peripheral blood monocytes and lymphocytes was performed by flow cytometry using monoclonal antibodies manufactured by Beckman Coulter (USA). The intracellular content of Granzyme B was carried out on a FC500 flow laser cytofluorimeter. The metabolic activity of neutrophils was assessed in the NBT test. Alpha defensin (Hycult biotech, USA) was determined in blood plasma by ELISA. Statistical analysis of the study results was performed using the Statistica 12.0 program (StatSoft, USA). Statistical significance was considered significant at p ≤ 0.05.Results: in patients with coronary atherosclerosis, the number of natural killers and their activity, monocytes, increases. There is an inhibition of antigen presentation processes, an imbalance in the microbicidal activity of neutrophils with a predominance of secretion of antimicrobial peptides. In the early period, significant changes only affected the decrease in the content of intracellular granzyme B on days 4-5, the expression of TLR4 and HLA DR on days 4-5 and 9-10. In the late postoperative period, in patients with coronary artery disease, there is a significant decrease in the content of lymphocytes: CD3+CD16+, CD16+Gr+, monocytes: CD14+CD282+, CD14+CD284+, CD14+CD289+, HBT-test activity and α-defensin content, and the number of monocytes expressing HLA DR increases.Conclusions: in patients with coronary heart disease, there are changes in the cellular component of innate immunity, indicating persistent inflammation. The dynamics of the revealed changes as a result of the performed stenting reflects the lability of the assessed indicators to a greater extent in the late postoperative period, which can serve as the basis for predicting the outcome of coronary stentin