Correlations between FoxP3+ regulatory T cells and computed tomography characteristics of adipose tissue in high-risk cardiovascular patients with coronary atherosclerosis of varying severity: a cross-sectional study

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BACKGROUND: Chronic subclinical inflammation caused by coronary atherosclerosis (CA) can be assessed more accurately using local biomarkers, such as regulatory T cells (Tregs) of epicardial (EAT) and thymic adipose tissue (TAT). However, this approach is limited by the high invasiveness, which requires the development of alternative methods for evaluating Treg markers. Among the available diagnostic procedures, multi-slice computed tomography (MSCT) has emerged as a valuable tool, offering a comprehensive assessment of the EAT parameters. AIM: This study aimed to examine the correlation of the characteristics of FoxP3+ regulatory T cells in peripheral blood, EAT, TAT, and subcutaneous adipose tissue (SAT) with MSCT findings of the EAT in high-risk patients with coronary atherosclerosis of varying severity. METHODS: The study included 20 patients with high cardiovascular risk, who were divided into groups based on their Gensini Scores (GS): severe CA group (GS 26.5; n = 13) and moderate CA group (GS 26.5; n = 7). The FoxP3 nuclear translocation and levels of CD4+CD25hiFoxP3 and CD4+CD25loFoxP3 Tregs were measured by flow cytometry and visualized in EAT, TAT, SAT, and peripheral blood. The volume and density of the EAT were assessed using MSCT. RESULTS: In the moderate CA group, a lower proportion of CD4+CD25hiFoxP3 Tregs was found in the TAT (6.12% [3.77%; 12.00%] vs. 13.5% [7.48%; 17.4%], p = 0.046). In the severe CA group, correlations were identified between the EAT density and the FoxP3 nuclear translocation for CD4+CD25hiFoxP3 Tregs in the TAT (rs = –0.63; p = 0.021) and CD4+CD25loFoxP3 Tregs in the SAT (rs = –0.58; p = 0.036). The findings demonstrate a notable bidirectional correlation between the FoxP3 nuclear translocation for CD4+CD25hiFoxP3 Tregs in the EAT and the EAT density in patients with varying severity of atherosclerosis (GS ≤26.5; rs = 0.79; p = 0.035 vs. GS 26.5; rs = –0.71; p = 0.006). In the peripheral blood of the severe CA group, a correlation was identified between the proportion of CD4+CD25loFoxP3 Tregs and the EAT volume (rs = –0.60; p = 0.006). CONCLUSIONS: The severe CA group demonstrated a series of inverse correlations between the EAT density and the FoxP3 nuclear translocation for all fat depots. These findings suggest a reduction in the immunosuppressive potential of Tregs in the context of CA progression. The results also indicate the viability of MSCT for the indirect assessment of the immunosuppressive potential of this cell population.

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