Innate immunity in cardiac myxomas and its pathological and clinical correlations

Abstract

Cardiac myxomas are the most common benign cardiac tumor. We investigated the immunohistochemical properties of 11 surgically excised cardiac myxomas, in order to analyze the correlation between macrophages and mast cell populations and clinical parameters. CD68/CD163/iNOS (M0) cells represent the most abundant macrophage phenotype; however, CD68/CD163 cells (M2) were also frequent. CD68/iNOS (M1) elements were rare. Mast cells, defined as a population of c-kit (CD117) and/or tryptase cells were also detected. Statistical analysis showed significant correlations between c-kit (CD117) and tryptase, CD68 and erythrocyte sedimentation rate (ESR), ESR and red blood cell count (RBC), and prothrombin time and platelet count. The inverse correlation between RBCs in peripheral blood and ESR suggested that anemia associated with chronic inflammatory disease is a noncasual event in patients suffering from cardiac myxoma. Mechanical hemolysis may be only a minor component of anemia, according to the lack of correlation between echographic surface and RBCs. Moreover, tumor size did not correlate with ESR, showing that inflammatory state may depend from both tumor cells population and inflammatory infiltrate. In the future, modulation of macrophage polarization in cardiac myxomas might represent important therapeutic target.

Innate Immunity: A Common Denominator between Neurodegenerative and Neuropsychiatric Diseases

“…Interestingly, CNS neoplasms with high immunogenicity, such as the choroid meningioma that can evoke a Castleman-like syndrome, could be associated with depressive symptoms, probably due to innate immunity imbalances [216][217][218]. A confirmation of the role of inflammation in generating depression may be further found in Castleman's disease, in its classical form [219], and in other diverse neoplasms that can trigger the same mechanisms, such as cardiac myxomas [220][221][222]. The main link between such inflammatory pathologies and depressive symptomatology could be the IL-6 secretion by activated macrophagic cells and, in turn, IL-6 modulates almost every aspect of the innate immune system [223].…”

Role of Macrophages in Brain Tumor Growth and Progression

“…These microglia elements that adopt an ameboid morphology are thought to reflect the transition to a phagocytic phenotype [ 69 , 70 ]. Since Ml macrophages express high levels of inducible nitric oxide synthase (iNOS; NOS2) to produce nitric oxide (NO) from arginine, this enzyme can be used as a reliable marker for classically polarized macrophages, mainly in confocal microscopy, in double stained CD68 + /iNOS + cells [ 31 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 ]. Activated microglia cells sometimes express iNOS and so that they may represent a precursor state towards classically activated M1 macrophages or an intermediate polarization condition, as the data obtained in animal models seem to suggest [ 80 , 81 , 82 ].…”

“…Recently, we have verified the behavior of some innate immunity cells in chordoid meningioma. Our results suggest that macrophages in CMs are mainly in a non-polarized or M2 (alternatively activated macrophages) state and their abundance might be associated with a major potential of relapse; additionally, there is an inverse correlation between the number of mast cells and macrophages [ 77 ].…”

Innate and Adaptive Immunity Linked to Recognition of Antigens Shared by Neural Crest-Derived Tumors

“…Some cardiac myxomas are characterized by Il-6 secretion corresponding to a clinical syndrome like Castleman disease. Moreover, the cardiac mixoma is characterized by infiltration of macrophages and mastocytes [108,109]. Sometimes, after surgical removal, myxomas re-emerge causing dysfunctional heart.…”