Prognostic value of Toll-like receptor 4 on human monocyte subsets combined with computed tomography-adapted Leaman score assessing coronary artery disease

Coron Artery Dis. 2023 Aug 1;34(5):356-363. doi: 10.1097/MCA.0000000000001250. Epub 2023 May 24.

Abstract

Background: Upregulation of Toll-like receptor 4 (TLR-4) is associated with coronary plaque vulnerability assessed by coronary computed tomography angiography (CCTA). Computed tomography-adapted Leaman score (CT-LeSc) is an independent long-term predictor of cardiac events. The relationship between the TLR-4 expression of CD14 ++ CD16 + monocytes and future cardiac events is unknown. We investigated this relationship using CT-LeSc in patients with coronary artery disease (CAD).

Methods: We analyzed 61 patients with CAD who underwent CCTA. Three monocyte subsets (CD14 ++ CD16 - , CD14 ++ CD16 + , and CD14 + CD16 + ) and the expression of TLR-4 were measured by flow cytometry. We divided the patients into two groups according to the best cutoff value of the TLR-4 expression on CD14 + CD16 + which could predict future cardiac events.

Results: CT-LeSc was significantly greater in the high TLR-4 group than the low TLR-4 group [9.61 (6.70-13.67) vs. 6.34 (4.27-9.09), P < 0.01]. The expression of TLR-4 on CD14 ++ CD16 + monocytes was significantly correlated with CT-LeSc ( R2 = 0.13, P < 0.01). The expression of TLR-4 on CD14 ++ CD16 + monocytes was significantly higher in patients who had future cardiac events than in those who did not [6.8 (4.5-9.1) % vs. 4.2 (2.4-7.6) %, P = 0.04]. High TLR-4 expression on CD14 ++ CD16 + monocytes was an independent predictor for future cardiac events ( P = 0.01).

Conclusion: An increase in the TLR-4 expression on CD14 ++ CD16 + monocytes is related to the development of future cardiac events.

MeSH terms

  • Coronary Angiography / methods
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / metabolism
  • Humans
  • Lipopolysaccharide Receptors / metabolism
  • Monocytes
  • Prognosis
  • Receptors, IgG / metabolism
  • Toll-Like Receptor 4 / metabolism
  • Tomography, X-Ray Computed

Substances

  • Toll-Like Receptor 4
  • Lipopolysaccharide Receptors
  • Receptors, IgG