Abstract TP228: Fluorescent Pegylated Nanoparticles are Localized in Macrophage-rich but Relatively Stable Human Carotid Atheromata
Background: Foam cell macrophages to produce matrix-disorganizing proteolytic enzymes may render atherosclerotic plaques prone to rupture, which causes thromboembolic stroke. Macrophages within atherosclerotic lesions were reported to take up low density lipoprotein (LDL)-sized nanoparticles by fluid-phase pinocytosis, indicating that fluid-phase pinocytosis of LDL is a mechanism for macrophage foam cell formation in vivo. Objective: To invesigate if fluorescent pegylated nanoparticles that are taken up by macrophages via pinocytosis could visualize vulnerable areas of human atheromata. Methods: Fresh carotid specimens from 36 patients undergoing carotid endarterectomy (after 3T carotid MRI) were tissue-cultured in DMEM (4 mL) with the fluorescent molecular imaging probe in 37°C CO 2 incubator. Before and 4 hours after the incubation, molecular optical imaging was performed using a Cy5.5 near-infrared fluorescent (NIRF) imaging machine with a charge-coupled device camera. The atherosclerotic plaques were classified according to the American Heart Association Report using 35 microsections (5μm thickness) from various pre-determined regions of selected carotid tissues (n=11). Immunohistochemical staining for macrophages (CD68) was performed using the avidin-biotin-peroxidase method. Results: High risk lesions (AHA Type IV ~ VIII) tended to show more frequent plaque regions with strong CD68 immunoreactivity (22 / 27) than did low risk lesion (2 / 8, p = 0.003). Unexpectedly however, low risk lesions (Type I: intial lesion with foam cells; Type II: fatty steak with multiple foam cell layers) tended to show more frequent in plaque regions with both strong CD68 immunoreactivity and high Cy5.5 NIRF signal (11 / 14) than the others (10 / 21, p = 0.07), suggesting that the nanoparticles could be taken up by relatively fresh foam cells in early atherosclerotic lesions rather than end-stage apoptonecrotic macrophages in advanced atheromata. Conclusion: Preliminary analysis of this on-going prospective study shows that fluorescent pegylated nanoparticles may localize macrophage-rich but relatively stable regions of human atheromata.