A study of the role of monocyte functional subpopulations in patients with carotid atherosclerosis and coronary artery disease

Jaipersad, Anthony S. (2014). A study of the role of monocyte functional subpopulations in patients with carotid atherosclerosis and coronary artery disease. University of Birmingham. M.D.

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Abstract

This thesis focuses on monocyte subsets and furthers the understanding of their relationships to the atherosclerotic disease process. A novel method of carotid contrast ultrasound (CEUS) is used in those with carotid disease (CD) and pre-existing coronary artery disease (CAD) to detect the presence of neovascularisation and correlates this with monocyte subset totals determined by flow cytometry/ enzyme- linked immunosorbent assay (ELISA).

Three monocyte subsets ((CD14++CD16-CCR2+ (Mon1), CD14++CD16+CCR2+ (Mon2) and CD14+CD16++CCR2- (Mon3)), are compared with severity of CD by division into 4 groups (each 40 patients); grp.1= CD>50% with pre-existing CAD, grp.2= CD<50% with pre-existing CAD, grp.3=hypercholesterolemia (HC), grp.4= normocholesterolaemic (NC). Monllevels were increased with severity of CD, and found to be predictive in those with increased carotid intima media thickness, a marker of systemic atherosclerosis. Mon3, was shown to be increased in those with moderate CD but not in the presence of severe disease.

Finally, monocyte levels where checked after cessation of statin therapy for two weeks, this did not affect monocyte subset counts but caused a reduction in inflammatory receptor expression on Monl. This thesis attempts to expand one's understanding of the behavioral heterogeneity of monocytes in atherosclerotic disease and demonstrates CEUS as a feasible research imaging method.

Type of Work:

Thesis (Higher Doctorates > M.D.)

Award Type:

Higher Doctorates > M.D.

Supervisor(s):