P17. Inquinamento ambientale e malattie cardiovascolari

Manuela Montanaro (1), Manuel Scimeca (2), Fabio Massimo Oddi (3), Francesca Servadei (2), Erica Giacobbi (2), Rita Bonfiglio (2), Arnaldo Ippoliti (3), Alessandro Mauriello (2).

(1) Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata - 00133, Roma, Italia.
(2) Dipartimento di Medicina Sperimentale, Università di Roma Tor Vergata - 00133, Roma, Italia.
(3) Unità di Chirurgia Vascolare - Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata - 00133, Roma, Italia.

---

Introduction: During the last few years, a greater characterisation and the identification of new potential cardiovascular risk factors became increasingly necessary to implement cardiovascular prevention strategies. To expand the knowledge about new histo-immunohistochemical indicators, the aim of this study is to investigate the possible association between some recurrent histopathologic/immunohistochemical features of carotid plaque instability and the occurrence of new potential cardiovascular risk factors. Among these, the possible role of chronic contaminants exposition was evaluated. Specifically, the presence of micro- or macrocalcifications, the expression of in-situ inflammatory biomarkers and the presence of pollutants, have been investigated in carotid plaques.

Methods: A total of 687 atheromatous plaques of symptomatic and asymptomatic patients have been enrolled to histologically evaluate the presence, location and size of micro- or macrocalcifications. Also, immunohistochemical stainings for the main inflammatory biomarkers were performed. In a smaller group of 57 patients Scanning Electron Microscopy combined with Energy Dispersive X-ray microanalysis evaluations were carried out.

 

Results: A very high rate of calcifications occurs in atheromatous lesions, with a statistically greater presence of microcalcifications in high inflamed unstable plaques; unexpectedly, macrocalcifications seem to paradoxically contribute to the stabilization of the plaque, also in combination with M2 macrophage polarization. As regards electron microscopy evaluations, the presence of aluminium was detected in 12 out of 57 carotid rings (incidence of >16%).

Discussion: Data here reported about the presence of ectopic calcifications and contaminants in carotid lesions constitute the foundation to scale-up the concept from a “comprehensive approach” to a “holistic approach” which takes into consideration co-morbidities, multifactorialities and the living context of the atherosclerotic patient. In conclusion, this new vision may provide fundamental details for both the management of patients affected by carotid atherosclerosis and the implementation of new strategies, aimed to prevent the occurrence of the most acute clinical events.