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- Title
Eosinophilic Coronary Periarteritis with Arterial Dissection: The Mast Cell Hypothesis.
- Authors
Mandal, Rakesh; Brooks, Erin G.; Corliss, Robert F.
- Abstract
A subset of coronary arterial dissections is associated with eosinophilic coronary periarteritis ( ECPA); however, the pathogenesis of the process remains unclear. Mast cells normally reside in coronary arterial adventitia and are known mediators of eosinophilic inflammatory conditions such as type I hypersensitivity reactions. We report two cases in which coronary arterial dissection with ECPA was detected at autopsy. Tryptase, CD68, CD4, CD8, and CD1a immunohistochemical staining was performed to better characterize inflammation. While eosinophils represented a prominent periadventitial inflammatory cell, there were slightly more lymphocytes: CD4/ CD8 ratios were within expected reference ranges. There were moderate numbers of macrophages, and few neutrophils or dendritic cells. Numbers of mast cells in dissected versus nondissected sections were compared: adventitial mast cell densities were threefold higher in dissected portions and showed a trend toward increased degranulation. These findings suggest that mast cells may play a role in orchestrating inflammation in cases of ECPA.
- Subjects
CORONARY disease; ARTERIAL dissections; MAST cell physiology; INFLAMMATORY mediators; FORENSIC cardiology
- Publication
Journal of Forensic Sciences, 2015, Vol 60, Issue 4, p1088
- ISSN
0022-1198
- Publication type
Article
- DOI
10.1111/1556-4029.12752