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J Am Coll Cardiol, 2008; 51:2444, doi:10.1016/j.jacc.2008.03.032
© 2008 by the American College of Cardiology Foundation
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CORRESPONDENCE: LETTER TO THE EDITOR

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Maria Lucia Narducci, MD, PhD*, Annalisa Grasselli, PhD, Luigi M. Biasucci, MD, FACC, Antonella Farsetti, MD, Antonino Mulè, MD, Giovanna Liuzzo, MD, Giampaolo Niccoli, MD, Rocco Mongiardo, MD, Alfredo Pontecorvi, MD and Filippo Crea, MD, FACC

* Institute of Cardiology, Catholic University of Sacred Heart, L.go A Gemelli 8, 00135 Rome, Italy (Email: lianarducci{at}yahoo.it).

We welcome the data provided by Dr. Sane, who found telomerase activation in cells from coronary atherectomy specimens (1). It is worth noting, however, that we assessed telomerase activation specifically in neutrophils from atherosclerotic plaques (2). We never found telomerase activation in neutrophils from stable patients, although we found it in about one-third of unstable patients, particularly in those with a recent episode of rest angina. Thus, our findings suggest that telomerase activation in neutrophils may be important in the early phases of coronary instability. In contrast, Dr. Sane found telomerase activation in about one-third of stable patients in cells obtained from coronary atherectomy specimens. Interestingly, they found a correlation between telomerase activation and restenosis rate, suggesting that telomerase reactivation in cells, which are not necessarily neutrophils, contained in stable atherosclerotic plaque may be important in the mechanism of restenosis. Therefore, the similar prevalence of telomerase activation in the 2 studies is probably just a coincidence. Nevertheless, both studies underscore the biological relevance of telomerase activation in the microenvironment of the atherosclerotic plaque and its different role in different clinical settings. In addition, both studies raise a number of unanswered questions. Why does telomerase activation occur only in a subset of patients? What are the molecular pathways leading to telomerase activation? What is the relationship between neutrophil telomerase activation in the plaque and levels of neutrophil activation markers in peripheral blood? What is the impact of telomerase activation in the microenvironment of the atherosclerotic plaque on the outcome in different clinical settings? Further studies are warranted to address these issues.


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 References
 

  1. Gupta M, Shogreen MR, Braden GA, White WL, Sane DC. Prevalence of telomerase in coronary artery atherosclerosis J Anti-Aging Med 2000;3:5-24.
  2. Narducci ML, Grasselli A, Biasucci LM, et al. High telomerase activity in neutrophils from unstable coronary plaques J Am Coll Cardiol 2007;50:2369-2374.[Abstract/Free Full Text]

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Telomerase-Positive Neutrophils: Plaque "Survivors" and Restenosis
David C. Sane
J. Am. Coll. Cardiol. 2008 51: 2443-2444. [Full Text] [PDF]




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