The accumulation of erythrocytes quantified and visualized by Glycophorin C in carotid atherosclerotic plaque reflects intraplaque hemorrhage and pre-procedural neurological symptoms

• DOI: 10.1038/s41598-023-43369-3
• Publication Date: 2023-10-10T13:02:30Z
• Authors: Joost M. Mekke; Tim R. Sakkers; Maarten C. Verwer; Noortje A. M. van...; Yipei Song; Clint L. Miller; Aloke V. Finn; Gerard Pasterkamp; Michal Mokry; Hester M. den Rui...; Aryan Vink; Dominique P. V. d...; Gert J. de Borst; Saskia Haitjema; Sander W. van der...
• Keywords: Glycophorin; Stroke; Atheroma; Immunostaining

Abstract The accumulation of erythrocyte membranes within an atherosclerotic plaque may contribute to the deposition free cholesterol and thereby enlargement necrotic core. Erythrocyte can be visualized quantified in by immunostaining for marker glycophorin C. Hence, we theorized that erythrocytes C could function as a vulnerability, possibly reflecting intraplaque hemorrhage (IPH), offering predictive value pre-procedural neurological symptoms. We employed CellProfiler-integrated slideToolKit workflow visualize quantify C, defined total area is positive single slides culprit lesions obtained from Athero-Express Biobank 1819 consecutive asymptomatic symptomatic patients who underwent carotid endarterectomy. Our assessment included evaluation various parameters such lipid core, calcifications, collagen content, SMC macrophage burden. These were evaluated using semi-quantitative scoring method, resulting data was dichotomized predefined criteria into categories no/minor or moderate/heavy staining. In addition, presence absence IPH also scored. prevalence symptoms 62.4% 87.1%, respectively. amount staining significantly higher samples men compared women (median 7.15 (IQR:3.37, 13.41) versus median 4.06 (IQR:1.98, 8.32), p < 0.001). Glycophorin associated with adjusted clinical confounders (OR 1.90; 95% CI 1.63, 2.21; = ipsilateral (OR:1.27, 95%CI:1.06–1.41, 0.005). Sex-stratified analysis, showed this case 1.37; 95%CI 1.12, 1.69; 0.003), but not 1.15; 0.77, 1.73; 0.27). classical features vulnerable plaque, larger burden, less lower content. There marked sex differences, men, calcifications while these associations found women. To conclude, independently IPH, preprocedural more composition both results strengthen notion used vulnerability.