Reduced T-Cell Thymic Export Reflected by sj-TREC in Patients with Coronary Artery Disease

J Atheroscler Thromb. 2016 May 2;23(5):632-43. doi: 10.5551/jat.31575. Epub 2016 Jan 12.


Aim: Immunologic dysfunction was recently found to be one of the most important mechanisms underlying the initiation and development of atherosclerosis. Thymus involution can contribute to immune disturbance and disequilibrium of T-cell subsets. This study aimed to explore whether recent thymic emigration (RTE) is impaired in patients with coronary artery disease (CAD).

Methods: Content of signal-joint T cell receptor excision circles (sj-TREC) in T lymphocytes, a molecular marker of RTE, was assessed among CAD patients and age-matched controls. Monochrome multiplex quantitative PCR method was used to assess the samples' telomere length in order to exclude the potential influence of T cell proliferation on the dilution of sj-TREC. Patients were grouped according to Gensini score (GS) (low, GS <18; intermediate, GS 18-41; high, GS >41). Ordinary logistic regression models were used to determine potential risk factors for CAD and GS tertiles.

Results: Average copy numbers of sj-TREC per 10(6) T lymphocytes among patients with unstable angina, stable angina, and controls were 726±429, 1213±465, and 1795±838, respectively (P<0.001). However, there was no significant difference in telomere length among groups. Moreover, the content of sj-TREC in the high GS group was most significantly reduced than the low GS group (P<0.001). Multivariate logistic regression analysis revealed that lower sj-TREC was independently associated with the progression of CAD (OR=0.44, P<0.001) and higher GS (OR=0.4, P<0.001).

Conclusion: Impaired RTE could be partly responsible for CAD development. Mechanisms may be involved in the disturbance of T lymphocyte compartment and interruption of maintained immune tolerance resulting from thymus involution.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Angina, Stable / blood
  • Angina, Unstable / blood
  • Cell Proliferation
  • Coronary Artery Disease / immunology*
  • Coronary Artery Disease / physiopathology
  • Female
  • Humans
  • Immune System
  • Lymphocyte Activation
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prospective Studies
  • Real-Time Polymerase Chain Reaction
  • T-Lymphocyte Subsets / cytology*
  • Telomere / ultrastructure