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CLINICAL STUDY

Increased expression of peripheral benzodiazepine receptors on leukocytes in silent myocardial ischemia

Antonino Mazzone, MD^*, Iolanda Mazzucchelli, BSc^*, Monia Vezzoli, MD^*, Elena Ottini, MD^*, Carla Auguadro, MD, Alessandra Serio, MD and Colomba Falcone, MD

^* Department of Internal Medicine and Nephrology, IRCCS, San Matteo Hospital, University of Pavia, Pavia, Italy
Department of Cardiology, IRCCS, San Matteo Hospital, University of Pavia, Pavia, Italy

Manuscript received August 29, 1999; revised manuscript received March 1, 2000, accepted April 13, 2000.

Reprint requests and correspondence: Dr. Antonino Mazzone, Adjunct Professor of Immunopharmacology, Department of Internal Medicine and Nephrology, University of Pavia, IRCCS, San Matteo Hospital, P.le Golgi 2, 27100 Pavia, Italy
a.mazzone{at}smatteo.pv.it

OBJECTIVES

The purpose of this study was to evaluate benzodiazepine receptor expression on leukocytes from patients with symptomatic or silent myocardial ischemia.

BACKGROUND

Silent myocardial ischemia is frequently observed in patients with coronary artery disease. Pain can be effectively controlled by various endogenous mechanisms. Benzodiazepines and their receptors play key roles in pain, in interactions with peptide opioids, in inflammation and in the response to stress.

METHODS

The study group consisted of 57 patients with reproducible exercise-induced myocardial ischemia. The presence of a constant behavior in the anginal pain perception during both exercise-induced ischemia and daily life was the most important inclusion criterion. Venous blood samples were taken from all patients to evaluate the expression of peripheral benzodiazepine receptors by flow cytometry. The study cohort was classified into two groups: 24 patients who had anginal pain both at home and during the exercise stress test and 33 patients who were asymptomatic during both daily life and exercise-induced ischemia.

RESULTS

Flow cytometry analysis showed increased expression of peripheral benzodiazepine receptors on all types of leukocytes in the asymptomatic patients. The difference was statistically significant for lymphocytes (p < 0.005), monocytes (p < 0.001) and granulocytes (p < 0.001).

CONCLUSIONS

These data show that expression of peripheral benzodiazepine receptors was higher in patients with silent myocardial ischemia than in symptomatic patients.

Abbreviations and Acronyms   CAD = coronary artery disease   DBI = diazepam-binding inhibitor   ECG = electrocardiogram or electrocardiographic   EST = ergometric stress test   GABA = -aminobutyric acid   MI = myocardial infarction   PBRs = peripheral benzodiazepine receptors   PBS = phosphate-buffered saline

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