Coronary disease & ACS

Toll-like receptor 2, hyaluronan, and neutrophils play a key role in plaque erosion: the OPTICO–acute coronary syndrome (ACS) study

Eur Heart JPublished Mechanistic study

Authors' conclusion

The current study provides first in-human evidence for distinct TLR2-mediated neutrophil activation in IFC-ACS, presumably triggered by elevated soluble hyaluronic acid.

Study context

Population
Patients with ACS from the OPTICO-ACS study; blood sampled at the culprit lesion and systemicallymatched
Comparison
IFC-ACS vs RFC-ACS
  • IFC-ACSn = 32
Outcome
Neutrophil activation in IFC-ACS vs RFC-ACS (TLR2 expression, MMP9 release, endothelial cell death, hyaluronidase 2/hyaluronic acid)
Methodological detailsmatched
  • Matched

Main finding

As reported in the abstract

  • TLR2 expression higher on neutrophils from IFC-ACS than RFC-ACS patients
  • TLR2 stimulation increased release of active MMP9 from local IFC-ACS-derived neutrophils
  • IFC-ACS-derived neutrophils aggravated endothelial cell death independently of TLR2
  • Thrombi of IFC-ACS patients exhibited more hyaluronidase 2, with increased local plasma hyaluronic acid (TLR2 ligand)

Original publication

Toll-like receptor 2, hyaluronan, and neutrophils play a key role in plaque erosion: the OPTICO–ACS study. Eur Heart J. Published 30 June 2023. doi:10.1093/eurheartj/ehad379

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