冠心病患者血小板中炎性受体NOD2、NF-κB的表达及其致炎机制

Expression of inflammatory receptor NOD2,NF-κB in platelets of patients with coronary heart disease and its inflammatory mechanism

目的研究核苷酸结合寡聚化结构域2(NOD2)受体在冠心病患者血小板中的表达水平,及其介导炎性反应的作用机制。方法纳入于2016年1月-2021年6月在本院住院冠心病患者120例,分别设定稳定型心绞痛(SAP)组患者40例,不稳定心绞痛(UAP)患者组40例,急性心肌梗死(AMI)患者组40例,并选取同期40例健康体检者作为对照组。应用荧光定量PCR法检测4组血小板NOD2受体、核因子-κB(NF-κB)表达水平,采用ELISA法检测4组的炎症因子超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)、白细胞介素6(IL-6)水平,并探讨其间的相关性。结果RT-PCR结果显示SAP组、UAP组和AMI组中NOD2 mRNA、NF-κB mRNA表达水平均较对照组升高(P<0.05),且AMI组较其他3组明显升高,差异有统计学意义(P<0.01)。ELISA法检测SAP组、UAP组、AMI组中炎症指标TNF-α、IL-6、hs-CRP与对照组比较均升高(P<0.05);AMI组较其他3组明显升高,差异均有统计学意义(P<0.01)。相关性分析发现血小板NOD2 mRNA与NF-κB mRNA、TNF-α、IL-6、hs-CRP呈正相关(相关指数r=0.418、r=0.615、r=0.338、r=0.389、P<0.001)。结论血小板NOD2受体与冠心病发展存在密切关系,且与NF-κB、hs-CRP、TNF-α、IL-6水平均呈正相关,说明其在血管内炎症发生过程中起着重要作用。

Objective To study the expression of nucleotide binding oligomerization domain 2( NOD2) receptor in platelets of patients with coronary heart disease( CHD) and its mechanism of mediating inflammatory response. Methods One hundred and twenty patients with coronary heart disease admitted to our hospital from January 2016 to June 2021 were enrolled in this study. There were 40 patients with stable angina pectoris( SAP group),40 patients with unstable angina pectoris( UAP group)and 40 patients with acute myocardial infarction( AMI). Another 40 healthy persons were selected as the control group. The expression of NOD2 receptor and nuclear factor-κB( NF-κB) in platelets of the four groups were detected by fluorescence quantitative PCR. The levels of high sensitivity C-reactive protein( hs-CRP),tumor necrosis factor α( TNF-α) and interleukin-6( IL-6) were measured by ELISA method. And the correlation between them was explored. Results The results of RT-PCR showed that the levels of NOD2 mRNA and NF-κB mRNA in SAP group,UAP group and AMI group were significantly higher than those in control group( P < 0. 05),and the expression of NOD2 mRNA and NF-κB mRNA in AMI group was significantly higher than that in the other three groups,with the differences statistically significant( P < 0. 01). The inflammatory indexes TNF-α,IL-6 and hs-CRP in SAP group,UAP group and AMI group were significantly higher than those in control group by ELISA method( P < 0. 05),and AMI group was higher than the other three groups,with the difference statistically significant( P < 0. 01). Correlation analysis showed that platelet NOD2mRNA was positively correlated with NF-κB mRNA,TNF-α,IL-6 and hs-CRP( r = 0. 418,r = 0. 615,r = 0. 338,r = 0. 389,P < 0. 001). Conclusion Platelet NOD2 receptor is closely related to the development of coronary heart disease,and is positively correlated with the levels of NF-κB,hs-CRP,TNF-α and IL-6. It shows that it plays an important role in the occurrence of intravascular inflammation.