To Örebro University

Background and Aims: Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis, affecting the lower limbs. T cells are among the principal contributors to the development of atherosclerotic plaques. However, T cell immune responses in PAD pathophysiology are poorly understood and a detailed phenotypic and functional characterization of T cell immune responses in PAD is needed.

Methods: Blood samples were collected from PAD patients with claudicatio intermittens (n=14) and healthy controls (HCs, n=30). We assessed the phenotype of active, effector and memory T cell subsets by evaluating the expression of specific surface and intracellular markers analysed by 10-colour flow cytometry. Functional responses were evaluated by performing T cell receptor (TCR) stimulation of PBMCs in a 3D cell culture system to assess cytokine production by ELISA. Statistical analyses were performed using the Mann-Whitney U test.

Results: No differences were observed between PAD and HCs in terms of active, effector and memory T cell phenotypes and in the frequency of cells expressing CCR6 and CXCR3 (markers associated with T cells producing IL-17 and IFN-γ). However, lower frequencies of IFN-γ+ cells among CD8+ (P=0.04), and CD4+CD8+ cells (P=0.03) were observed in PAD compared to HCs. TNF-α production in PAD-derived PBMCs, via TCR stimulation was increased at both 48- (P=0.004) and 72-hour time points (P=0.003). No differences were observed in IL-1β, IFN-γ and IL-17 secretion.

Conclusions: Taken together these results suggest that increased TNF-α secretion by PBMCs in response to TCR activation might contribute to the pro-inflammatory environment in PAD pathogenesis.