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. 2011 Jan;32(1):84-92.
doi: 10.1093/eurheartj/ehq371. Epub 2010 Oct 12.

CD14++CD16+ monocytes and cardiovascular outcome in patients with chronic kidney disease

Kyrill S Rogacev  1 , Sarah Seiler, Adam M Zawada, Birgit Reichart, Esther Herath, Daniel Roth, Christof Ulrich, Danilo Fliser, Gunnar H Heine
Affiliations

CD14++CD16+ monocytes and cardiovascular outcome in patients with chronic kidney disease

Kyrill S Rogacev et al. Eur Heart J. 2011 Jan.

Abstract

Aims: Patients with chronic kidney disease (CKD) pose a worldwide growing burden to health care systems due to accelerated atherosclerosis and subsequent high cardiovascular (CV) morbidity. Atherogenesis is prominently driven by monocytes and monocyte-derived macrophages. The expression of CD14 and CD16 characterizes three monocyte subsets: CD14(++)CD16(-), CD14(++)CD16(+), and CD14((+))CD16(+) cells; the latter two are often denoted as 'proinflammatory' CD16(+) monocytes. Despite an association between CD16(+) monocyte counts and higher CV risk in cross-sectional cohorts, the prognostic impact of elevated CD16(+) monocyte counts is poorly understood.

Methods and results: We assessed monocyte heterogeneity using flow cytometry in 119 patients with non-dialysis CKD, who were prospectively followed for a median of 4.9 (inter-quartile range 4.8-5.0) years for the occurrence of CV events. In addition, we assessed expression of chemokine receptors on monocyte subsets. CD14(++)CD16(+) monocyte were independently associated with CV events [hazard ratio (for an increase of 10 cells/μL) 1.26 (confidence interval: 1.04-1.52; P = 0.018)] after adjustment for variables that significantly affected CD14(++)CD16(+) cell counts at baseline. Across the spectrum of CKD, CD14(++)CD16(+) monocytes selectively expressed CCR5.

Conclusion: We found that CD14(++)CD16(+) monocytes were independently associated with CV events in non-dialysis CKD patients. Our results support the notion that CD16(+) monocytes rather than CD16(-) monocytes are involved in human atherosclerosis.

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