Calcification and Apoptosis of Blood Cells as a Marker of the Presence, Severity and Progression of Coronary Heart Disease Associated with Type 2 Diabetes Mellitus: Ultrastructural and Cytological Studies
Background. The increase of intercellular content of Ca2+ leads to the initiation of apoptosis processes and calcification of the cells of the blood and cardiovascular system. The close relationship between the apoptosis of blood cells and their calcification gives reason to believe that calcium is an important marker and initiator of this process. Objective of the study — to follow-up ultrastructural changes and the state of cellular immunity in patients with acute coronary syndrome (ACS) and type 2 diabetes mellitus (DM), and to identify the association between increased intracellular calcium in red blood cells and calcification of coronary arteries. Materials and methods. The study involved 20 patients with ACS associated with type 2 DM. The control group included 10 persons. The average age of patients was 65.0 ± 5.6 years. The following examinations were performed: multispiral computed tomography; cytological determination of calcium salts in red blood cells using McGee-Russell method; immunological study of leukocyte apoptosis by means of ApoLect set; electron microscopy for detection of ultrastructural signs of blood cell apoptosis. Results. In patients with high and very high index of calcification of the coronary arteries, the presence of calcium granules of various sizes and shapes in red blood cells can be detected cytologically, as well as aniso- and poikilocytosis; immunologically — an increase in the number of apoptotically altered blood cells and the appearance of necrotically modified ones; also, classic ultrastructural signs of leukocyte apoptosis are typical. Conclusions. The presence of ACS in patients with type 2 DM is associated with activation of leukocyte apoptosis processes, accumulation of calcium ions in red blood cells, which is accompanied by a high and very high index of calcification of the coronary arteries. Detection of such changes in the study of peripheral blood of patients enables to suspect timely the threat of coronary heart disease and to prevent its serious complications.
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