Presence of B cells within aortic valves in patients with aortic stenosis: Relation to severity of the disease

• Published in: Journal of cardiology 2016-01, Vol.67 (1), p.80-85
• Main Authors: Natorska, Joanna, PhD, Marek, Grzegorz, MD, PhD, Sadowski, Jerzy, MD, PhD, Undas, Anetta, MD, PhD
• Format: Article
• Language: English
• Subjects: Aortic stenosis; Aortic Valve - metabolism; Aortic Valve - pathology; Aortic Valve Stenosis - pathology; B cells; B-Cell Activation Factor Receptor - metabolism; B-Lymphocytes - pathology; Calcification; Calcinosis - pathology; Cardiovascular; Female; Humans; Immunohistochemistry; Inflammation; Macrophages - metabolism; Male; Middle Aged; Severity of Illness Index
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2015.05.002

Abstract Background Aortic stenosis (AS) shares several similarities with atherosclerosis. Recent reports showed that B cells are implicated in atherosclerosis progression through macrophage–B cells bidirectional interaction. We aimed to study the in loco presence of B cells within aortic valves and to determine its modulators. Methods Thirty-seven patients with severe AS were studied. Immunohistochemistry was performed on valve leaflets using antibodies against CD20, B cell-activating factor of the tumor necrosis factor family receptor (BAFF-R) and CD68. Plasma inflammatory markers were also determined. Results The B cells were detected within aortic leaflets from 5 to 31/mm2 (17.9 ± 11.6/mm2 ). Double-staining showed that 27 ± 13.5% of B cells express BAFF-R. There were positive correlations between the number of B cells and macrophages ( r = 0.45, p = 0.018), and between macrophages and B cell-associated BAFF-R expression ( r = 0.66, p = 0.002). The number of B cells was associated with the valve calcification ( r = 0.41, p = 0.039), and with the maximum transvalvular gradient ( r = 0.63, p = 0.02). The BAFF-R expression was positively correlated with maximum transvalvular gradient ( r = 0.39, p = 0.031) and negatively with aortic valve area ( r = −0.41, p = 0.048). There were no correlations between the number of B cells and plasma markers. Conclusions It might be hypothesized that, like in atherosclerosis, increasing number of B cells within aortic valves may accelerate inflammation and thus potentiate the progression of AS.