Assessment of C-Reactive Protein/Serum Albumin Ratio in Relation to Acute Presentation and Early Outcome of Patients with Acute Coronary Syndrome

Background: Acute coronary syndrome (ACS) is the leading cardiovascular (CV) cause of mortality. C reactive protein (CRP) has linked with long-term risk of recurrent cardiovascular events or death. Albumin, in contrast to CRP known as a negative acute-phase protein. Thus a newly introduced marker assessed relation of CRP to albumin ratio (CAR), which may provide better results than the use of either marker alone. The aim of the study is to assess the association of C-reactive protein to albumin ratio (CAR) with in-hospital short-term major adverse cardiac events (MACEs) in acute coronary syndrome (ACS) patients. Patients & Methods: A multi-centers prospective cohort study was conducted at coronary intensive care units (CICU) in Baghdad during the period from March to October 2021 that included a total of 132 patients who were diagnosed as a case of ACS. They were assessed for major adverse cardiac events (MACEs) like cardiogenic shock, arrhythmias, post-MI angina, and acute heart failure while inside the ward, in addition to need for early interventional therapeutic approach in relation to (CAR) immediately at time of admission to hospital. Results: High values of CAR, whether using hs-CRP or CRP, were identified as an independent predictor for in-hospital MACEs (P value Conclusion: The CAR was independently correlated with in-hospital short-term MACEs and can be used for risk stratification in patients with ACS.

Changes of serum high sensitive C-reactive protein in patients with acute cerebral infarction

BACKGROUND： Serum high sensitive C-reactive protein （hs-CRP）, which regards as a high sensitive mark of systemic inflammatory response syndrome, can provide a lot of valuable information for the treatment and prognosis of cerebrovascular disease. OBJECTIVE： To observe the differences of blood glucose, lipid, homocysteine and previous disease history among patients with acute cerebral infarction at various levels of hs-CRP and compare changes of hs-CRP of patients with various degrees of neurologic impairment. DESIGN： Contrast observation. SETTING： Department of Neurology, Shenzhou Hospital, Shenyang Medical College. PARTICIPANTS： A total of 102 patients with acute cerebral infarction were selected from Department of Neurology, Shenzhou Hospital of Shenyang Medical College from February 2005 to September 2006, including 55 males and 47 females aged from 55 to 86 years. All accepted patients met the diagnostic criteria of cerebral infarction established by the Fourth National Cerebrovascular Disease Academic Meeting and were diagnosed with CT or MRI examination. All patients provided the confirmed consent. Based on clinical criteria of neurologic impairment established by the Fourth National Cerebrovascular Disease Academic Meeting, patients were randomly divided into mild group （0 - 15 points, n =46）, moderate group （16 - 30 points, n =38） and severe group （31 - 45 points, n =18）. In addition, based on hs-CRP level within 72 hours, patients were divided into normal group （hs-CRP ≤3 mg/L, n =53） and increasing group （hs-CRP 〉 3 mg/L, n =-49）. METHODS： ① 2 mL venous blood was selected from hospitalized patients in the next morning to separate serum. Quantitative measurement of hs-CRP was dealt with Latex Enhnced Turbidimetric Immunoassay （LETIA）. ②Fasting venous blood was colleted from hospitalized patients in the next morning to measure numeration of white blood cells, fibrinogen, blood glucose, total cholesterol （TC）, triacylglycerol （TG）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C） and homocysteine. ③Measurement data were compared with t test or analysis of variance. MAIN OUTCOME MEASURES： ①Comparisons of serum biochemical indexes among patients with various levels of hs-CRP; ②comparisons of risk factors among patients with various levels of hs-CRP; ③comparisons of levels of hs-CRP among patients with various degrees of clinical neurologic impairment. RESULTS： A total of 102 patients were involved in the final analysis. ①Plasma fibrinogen and numeration of leucocytes were more in the increasing group than those in the normal group （t =4.39, 3.54, P 〈 0.01）; while, there were no significant differences of blood glucose, TC, TG, HDL-C, LDL-C and homocysteine between the two groups （P 〉 0.05）. ② Percentage of patients with hypertension and diabetes mellitus （DM） was higher in the increasing group than the normal group （ Х^2=3.98, 4.23, P 〈 0.05）; while, percentage of patients with smoking in the increasing group was not significantly different from that of patients in the normal group （P 〉 0.05）. ③Level of hs-CRP of patients with severe neurologic impairment was higher than that of patients with moderate neurologic impairment （t =2.273, P 〈 0.05）; that of patients with moderate neurologic impairment was higher than that of patients with mild neurologic impairment （t =2.586, P 〈 0.05）; that of patients with severe neurologic impairment was obviously higher than that of patients with mild neurologic impairment （t = 4.913, P 〈 0.01）. CONCLUSION： ① With the increase of hs-CRP, plasma fibrinogen and numeration of leucocytes of patients with acute cerebral infarction is increased, especially, they are increased remarkably among patients who have history of diabetes mellitus and hypertension. ②Increase of level of hs-CRP can be regarded as one of marks to evaluate severity of acute stroke.

Elevated levels of inflammatory cytokines and high-sensitivity C-reactive protein in periodontitis patients in Kosovo: A pilot study

The following article has been retracted due to the investigation of complaints received against it. The Editorial Board found that the same contents have been published in another journal at the same time. The scientific community takes a very strong view on this matter, and the Open Journal of Stomatology treats all unethical behavior such as plagiarism seriously. This paper published in Vol.3 No.1 32-38, 2013 has been removed from this site. Title: Elevated levels of inflammatory cytokines and high-sensitivity C-reactive protein in periodontitis patients in Kosovo: A pilot study Authors: Zana Sllamniku-Dalipi, Hasan Mehmeti, Fatmir Dragidella, Ferit Kocani, Metush Disha, Kastriot Meqa, Luljeta Begolli, Gramos

Combined Effects of Family History of Cardiovascular Disease and Serum C-reactive Protein Level on the Risk of Stroke: A 9.2-year Prospective Study among Mongolians in China

Objective We aimed to evaluate the combined effect of a family history of cardiovascular disease（CVD） and high serum C‐reactive protein（CRP） on the stroke incidence in an Inner Mongolian population in China. Methods A prospective cohort study was conducted from June 2002 to July 2012, with 2,544 participants aged 20 years and over from Inner Mongolia, China. We categorized participants into four groups based on the family history of CVD and CRP levels. Results We adjusted for age; sex; smoking; drinking; hypertension; body mass index; waist circumference; and blood glucose, triglycerides, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol levels. Compared with the group with no family history of CVD/low CRP levels, the group with family history of CVD/high CRP levels had a hazard ratio（HR） of 1.78 [95% confidence interval（CI）, 1.03‐3.07; P = 0.039] of stroke, and an HR of 2.14（95% CI, 1.09‐4.20; P = 0.027） of ischemic stroke. The HRs of hemorrhagic stroke for the other three groups were not statistically significant（all P 〉 0.05）. Conclusion Participants with both a family history of CVD and high CRP levels had the highest stroke incidence, suggesting that high CRP levels may increase stroke risk, especially of ischemic stroke, among individuals with a family history of CVD.

Correlation between serum C1q tumor necrosis factor-related protein 4 and high-sensitivity C-reactive protein levels and coronary heart disease

Objective:To investigate the relationship between serum levels of C1q tumor necrosis factorrelated protein 4(CTRP4)and hypersensitive C reactive protein(hs-CRP)and coronary heart disease(CHD)and its clinical value.Methods:128 patients underwent coronary angiography in our hospital,63 males,65 women,Based on blood sugar levels and coronary angiography,Divided into pure coronary heart disease(CHD)group 62 cases,Coronary heart disease with diabetes(DM+CHD)group 66 cases,A total of 126 patients were selected as control group,65 men,61 women,CTRP4 and hs-CRP levels in serum,Using Pearson correlation analysis to assess the correlation between Gennisi score and CTRP4、hs-CRP,Analysis of three groups of biochemical indicators,CTRP4、hs-CRP level changes and clinical significance.Results:The CTRP4、hs-CRP level of DM+CHD group was significantly higher than that of control group and CHD group(P DM+CHD 0.05).The CTRP4、hs-CRP level of the three-vessel coronary artery lesion group in the experimental group was higher than that in the two-vessel lesion group(P﹤0.05),Double branch lesion group was higher than single branch lesion group(P﹤0.05);Correlation analysis shows,There was a significant positive correlation between the CTRP4、hs-CRP level of CHD group and DM+CHD group and the Gennisi score(P DM+CHD 0.05).ROC curves show,CTRP4 and hs-CRP levels had predictive value(CHD group,AUC=0.940,0.934,DM+CHD group,AUC=0.980,0.964),Two associations(CHD:AUC=0.961,P﹤0.001,DM+CHD group:AUCDM+CHD 0.982,P﹤0.001)the predictive value is high.Conclusion:Serum CTRP4 and hs-CRP are positively related to the severity of coronary heart disease,and the sensitivity and specificity of predicting coronary heart disease are high,which is helpful for the identification and early prevention of coronary heart disease,and has certain clinical reference value.

Effects of Soymilk on Serum Insulinemic Status and High Sensitivity C-Reactive Protein Levels in Healthy Postmenopausal Women of Bangladesh

Background: Postmenopausal women are at increased risk for cardiac diseases because many risk factors are aggravated by menopause. Isoflavones are phytoestrogens present in natural sources, and they may modulate risk factors favorably, involving mechanisms similar to estrogen. The study aimed to assess the effects of soymilk on serum insulinemic status and hs-C reactive protein (CRP) levels of postmenopausal women of Bangladesh. Methods: Thirty-six women (aged 50 ± 5 years, M ± SD) participated in a randomized, un-blind, open-ended, crossover study design for 52 days. During the study period, the patients made four visits (before and after the intervention including the washout period). The soymilk group consumed 350 mL of milk twice a day for 21 days;the milk contained ~30 mg of isoflavones. Fasting blood glucose (FBG), postprandial glucose (PPG), HbA1c, serum insulin, and hs-CRP were measured on day 0, day 21, day 31, and day 51 with a 10-day washout period. Paired t-test was performed to determine the effects of soymilk on the CVD risks among postmenopausal women and a student t-test was performed for group comparison. Statistical tests were considered significant at p value of ≤0.05. Results: The mean (±SD) BMI of the postmenopausal women was 25.14 ± 3.55 kg/m2. In the consumption of soymilk no significant changes were found in glycemic, insulinemic, and hs-CRP levels between and within the groups. After crossover, a significant change was observed in FBG (5.18 ± 0.49 vs 5.56 ± 0.43, p = 0.005) in the soymilk group. No significant changes were observed in other parameters within or between the groups. However, FBG and hs-CRP levels were found to improve but not significantly at the end of 51 days. Conclusions: Soy isoflavones did not improve serum insulinemic status and hs-C reactive protein (CRP) levels among Bangladeshi postmenopausal women. Further studies need to be elucidated by considering a follow-up study with a large sample size.

C-reactive protein as a risk factor for acute coronary syndrome

Objective We assessed the levels of C reactive protein (CRP)in patients with acute coronary syndrome (ACS) [including unstable angina pectoris (UAP), acute myocardial infarction (AMI) and sudden cardiac death (SCD)] compared with non ACS [including stable angina pectoris (SAP), old myocardial infarction (OMI) and healthy volunteers] and sought to test whether CRP are associated with clinical acute coronary syndrome. Methods Ultrasensitive immunoassay (rate nephelometry with the Beckman Array multitest immunoassay system) was used to measure CRP levels in 91 patients with ACS (20 UAP, 71 AMI including 2 SCD) and non ACS (34 SAP, 25 patients with healing phase of AMI , 41 OMI and 94 control healthy subjects). Results CRP levels were higher in ACS group (18.50±23.98 mg/L [SE 2.51, n=91]) compared with non-ACS group (3.89±7.14 mg/L [SE 0.51, n=194]) (P< 0.01). Using Logistic Regression, CRP was a potent determinant of ACS(OR=1.65). Conclusion These results suggest that CRP has a strong association with ACS, and CRP is a risk factor of ACS.

Effects of XUEZHIKANG on Oxidized Low Density Lipoprotein,C - Reactive Protein, Fibrinogen in Unstable Angina Pectoris Patients

Objectives To study the effects of XUEZHIKANG on lipid modulating and the level of oxidized low density lipoprotein(OX - LDL), C -reactive protein(CRP), fibrinogen(FIB) in serum. Methods XUEZHIKANG was given to patients with unstable angina pectoris and hyperlipidemia at a dose of 0. 6 gram bid for 2 months and with half -dose for another 2 months. Vitamin E was given to unstable angina pectoris patients with normal lipid at the dose of 0. 1 gram bid for 4 months respectively. Then compared the level of lipid and OX - LDfL, CRP, FIB in serum at beginning, first - month and second -month. Results XUEZHIKANG can reduce the serum level of total cholesterol, low density lipoprotein in 1 month , and gained better effect in 2 months. It can also reduce triglyceride and increase high density lipoprotein in 2 months. Compared with vitamin E XUEZHIKANG can reduce the level of OX - LDL, CRP, FIB significantly after treatment for 2 months. Conclusions XUEZHIKANG has significant effect in lipid modulating , and it can also inhibit the development of inflammation in coronary plaque.

~rognostic value of baseline C-reactive protein levels in patients mdergoing coronary revascularization

Background C-reactive protein （CRP） is a lowly expressed marker for inflammatory response. This study aimed to evaluate the prognostic value of baseline CRP levels in patients undergoing coronary revascularization in the context of modern medical treatment. Methods This was a retrospective study in a single center. Four hundred and fourteen patients were enrolled, who underwent coronary revascularization and received adequate medication for secondary prevention of coronary heart disease. The study compared the follow-up clinical outcomes between high level CRP group （CRP 〉5 mg/L） and low level one. The median follow-up time was 551 days. Results Compared with low CRP group, the relative risk （RR） of the major adverse cardiovascular and cerebral events （MACCE） in high CRP group was 5.131 （95% CI： 1.864-14.123, P=0.002）. There were no significant differences in death myocardial infarction and stroke during the follow-up between two groups, but a higher risk of re-revascularization was found in high CRP group （RR 6.008, 95% CI： 1.667-21.665, P=0.006）. Cox regression analysis showed that only CRP level could contribute to MACCE during the follow-up. MACCE-free rate was much lower in high CRP group （Kaplan-Meier log-rank P 〈0.001）. Conclusion In the context of modern medical treatment, the baseline level of CRP is an independent predictor for long-term prognosis in patients with coronary revascularization.

Physiological evidence of integrin-antibody reactive proteins influencing the innate cellular immune responses of larval Galleria mellonella hemocytes

Larval Galleria melonella(L.)hemocytes form microaggregates in response to stimulation by Gram-positive bacteria Hemocyte adhesion to foreign materials is mediated by the CAMP/protein kinase A pathway and the B-subunit of cholera toxin using a cAMP-independent mechanism.Cholera toxin-induced microaggregation was inhibited by the integrin inhibitory RGDS peptide,implying integrins may be part of the mechanism.Based on the types of mammalian integrin-antibody reactive proteins affecting hemocyte adhesion and bacterial-induced responses ars,ory,Ai,and B3 subunits occred on both granular cell and plasmatocyte hemocyte subtypes.A fluorescent band representing the binding of rabbit as-integrin subunit antibodies occurred between adhering heterotypic hemocytes.The frequency of the bands was increased by cholera toxin.The as andβrabbit integrin subunit antibodies inhibited removal of Bacillus subtilis(Cohn)from the hemolymph in vivo,A as ir-specific synthetic peptide blocker similarly diminished hemocyte function whereas the 0v Bs-specific inhibitory peptide and the corresponding integrin subunit antibodies did not influence nonself hemocyte activities.Western blots revealed several proteins reacting with a given integrin-antibody subtype.Thus integrin-antibody reactive proteins(which may include integrins)with possible as and B epitopes modulate immediate hemocyte function.Confocal microscopy established plasmatocyte adhesion to and rosetting over substrata followved by granular cell microaggregate adhesion to plasmatocytes during early stage nodulation.

Role of doxycycline in the treatment of dengue infection: An open-label, randomized, controlled, pilot trial

Objective:To measure the effect of doxycycline on inflammatory marker[IL-6,TNF-α,ferritin and C reactive protein(CRP)]levels in patients with dengue infection.Methods:A single-centre,open-label,parallel-group randomized controlled trial was done in PGIMER Chandigarh from June 2021 to October 2022.Patients were randomized using a simple randomization process into two groups:the doxycycline treatment group(n=35)and the control group(n=34).Patients in the treatment group were given oral doxycycline 100 mg twice daily for five days along with standard treatment,whereas patients in the control group received only standard treatment.The objective was to measure the effect of doxycycline on inflammatory markers in dengue infection.Results:On comparative analysis at day 5,there was a statistically significant reduction in the median values of ferritin and CRP in cases compared to the control group(ferritin:P=0.006 and CRP:P=0.006).No significant reduction was noted in the levels of IL-6 and TNF-α.Conclusions:Doxycycline treatment led to a reduction of inflammatory markers in dengue infection.

Physical and chemical changes of rapeseed meal proteins during toasting and their effects on in vitro digestibility

Background： Toasting during the production of rapeseed meal（RSM） decreases ileal crude protein（CP） and amino acid（AA） digestibility. The mechanisms that determine the decrease in digestibility have not been fully elucidated. A high protein quality, low-denatured, RSM was produced and toasted up to 120 min, with samples taken every 20 min. The aim of this study was to characterize secondary structure and chemical changes of proteins and glucosinolates occurring during toasting of RSM and the effects on its in vitro CP digestibility.Results： The decrease in protein solubility and the increase of intermolecular β-sheets with increasing toasting time were indications of protein aggregation. The contents of NDF and ADIN increased with increasing toasting time.Contents of arginine, lysine and O-methylisourea reactive lysine（OMIU-RL） linearly decreased with increasing toasting time, with a larger decrease of OMIU-RL than lysine. First-order reactions calculated from the measured parameters show that glucosinolates were degraded faster than lysine, OMIU-RL and arginine and that physical changes to proteins seem to occur before chemical changes during toasting. Despite the drastic physical and chemical changes noticed on the proteins, the coefficient of in vitro CP digestibility ranged from 0.776 to 0.750 and there were no effects on the extent of protein hydrolysis after 120 min. In contrast, the rate of protein hydrolysis linearly decreased with increasing toasting time, which was largely correlated to the decrease in protein solubility, lysine and OMIU-RL observed. Rate of protein hydrolysis was more than 2-fold higher for the untoasted RSM compared to the 120 min toasted material.Conclusions： Increasing the toasting time for the production of RSM causes physical and chemical changes to the proteins that decrease the rate of protein hydrolysis. The observed decrease in the rate of protein hydrolysis could impact protein digestion and utilization.

Transcutaneous Auricular Vagus Nerve Stimulation Ameliorates Preeclampsia-Induced Apoptosis of Placental Trophoblastic Cells Via Inhibiting the Mitochondrial Unfolded Protein Response

Preeclampsia is a serious obstetric complication.Currently,there is a lack of effective preventive approaches for this disease.Recent studies have identified transcutaneous auricular vagus nerve stimulation(taVNS)as a potential novel non-pharmaceutical therapeutic modality for preeclampsia.In this study,we investigated whether taVNS inhibits apoptosis of placental trophoblastic cells through ROS-induced UPRmt.Our results showed that taVNS promoted the release of acetylcholine(ACh).ACh decreased the expression of UPRmt by inhibiting the formation of mitochondrial ROS(mtROS),presumably through M3AChR.This reduced the release of pro-apoptotic proteins(cleaved caspase-3,NF-kB-p65,and cytochrome C)and helped preserve the morphological and functional integrity of mitochondria,thus reducing the apoptosis of placental trophoblasts,improving placental function,and relieving preeclampsia.Our study unravels the potential pathophysiological mechanism of preeclampsia.In-depth characterization of the UPRmt is essential for developing more effective therapeutic strategies for preeclampsia targeting mitochondrial function.

Protection of Salvianolate against Atherosclerosis via Regulating the Inflammation in Rats

Inflammation plays an essential role in the pathophysiology of atherosclerosis. Our study was aimed to investigate whether salvianolate, a novel water-soluble phenolic compound of Danshen, alleviates atherosclerosis via regulating the inflammation in rats. High fat diet feeding plus vitamin D3 injection was used to induce atherosclerosis in rats. Salvianolate （60, 120 or 240 mg/kg） or placebo was given to atherosclerotic rats. The plasma lipids, interleukin 6 （IL-6） and C reactive protein （CRP） were measured by ELISA. CD4＋CD25＋Foxp3＋ cells were determined by flow cytometry. Histological changes were examined by hematoxylin and eosin staining. The results showed that the levels of plasma IL-6 and CRP were elevated in the rats fed on high fat diet, and the histological analysis demonstrated the successful establishment of atherosclerosis models. Treatment with salvianolate alleviated the atherosclerotic process and decreased the levels of plasma IL-6 and CRP. Also the number of CD4＋CD25＋Foxp3＋ cells was increased in salvianolate-treated rats. It was concluded that salvianolate could treat atherosclerosis via modulating the inflammation at cytokine and cell levels.

Blockage of PPARδ increases the expression of inflammatory factors in 3T3-L1 cells stimulated with TNFα

Objective： To investigate the role of peroxisome proliferator-activated receptors δ （PPARδ） in inflammatory reaction and its possible mechanism in adipocyte. Methods：Lentivirus-mediated RNA interference （RNAi） was used to block the expression of PPARδ in 3T3-L1 cells. In order to induce inflammation in 3T3-L1, cells were stimulated with tumor necrosis factor-α（TNFα, 20 ng/ml） for 4 h. The expression of PPARδ, nuclear factor κB （NFκB） and C reactive protein （CRP） were determined by Western blot analysis. Results：The expression of PPARδ was reduced by 80% after RNAi. Blockage of PPARδ promoted the expression of CRP and NFκB in cells stimulated with TNFα but had no effect on normal cells. Conclusion： PPARδ is involved in inflammatory reaction in adipocyte. Blockage of PPARδ can promote the inflammation mediated by inflammatory factors and increase the expression of NFκB and CRP in 3T3-L1 cells stimulated with TNFα.

Interaction of C-reactive Protein with Artificial Lipid Containing Monolayers Studied by Ellipsometric Microscope

In order to study the interaction between C reactive protein (CRP) and a biomembrane, an artificial phospholipid with a long spacer, DS8PC, was synthesized. Also, a new microscope, ellipsometric microscope (EMM), was designed and constructed for studying film surfaces. Using the self made EMM specific interaction of rabbit C reactive protein (rCRP) with DS8PC containing monolayers was studied.

Interaction of Rabbit C-reactive Protein with Phospholipid Monolayers at Air/Water Interface

C reactive protein (CRP) is a major acute phase reactant in most mammalian species. The recognition and the binding principles of CRP to its substrates are not well known. In this paper the interaction of rabbit CRP (rCRP) with lipid monolayers at the air/water interface was studied. From the experiments it was concluded that rCRP molecules were amphipathic, and rCRP molecules might interact with phospholipid monolayers by hydrophobic force. The critical surface pressure of rCRP interacting with phospholipid monolayers is about 34 5 mN/m.

The Cross-talk between ROS and p38MAPKα in the Ex Vivo Expanded Human Umbilical Cord Blood CD133^+ Cells

This study investigated the correlation between and compared the effects of reactive oxygen species（ROS） and p38 mitogen-activated protein kinase α（p38MAPKα） in the ex vivo expanded umbilical cord blood（hUCB） CD133＋ cells.hUCB CD133＋ cells were cultured in the hematopoietic stem cells（HSCs） culture medium with N-acetylcysteine（NAC,an anti-oxidant）,p38MAPKα-specific inhibitor（SB203580） or their combination.The levels of ROS and expression of phosphorylated p38MAPKα（p-p38） in CD133＋ cells were flow cytometrically detected.The efficacy of ex vivo expansion was evaluated by the density of CD133＋ cell sub-group colony-forming cells（CFC） and cobblestone area-forming cells（CAFC） assay.Our results showed decreased ROS levels in NAC,SB203580,and their combination treatment groups were almost 37%,48%,and 85%,respectively.Furthermore,SB203580 abrogated the activation of p38MAPKα more obviously than NAC.Moreover,the CD133＋ cells in SB203580 treatment group had a 21.93±1.36-fold increase,and 14.50±1.19-fold increase in NAC treatment group,but only 10.13±0.57-fold increase in control group.In addition,SB203580 treatment led a higher level increase in the number of CFU and CAFC than NAC did.These findings suggested that,in expanded CD133＋ cells,ROS activates p38MAPKα,which,in turn,induces ROS production,and p38MAPKα might be the most suitable regulator in ROS-p38MAPKα pathway for the promotion of HSCs ex vivo expansion.

The microsatellite polymorphism of heme oxygenase-1 is associated with baseline plasma IL-6 level but not with restenosis after coronary in-stenting

Background Vascular smooth muscle cells （VSMCs） can express heme-oxygenase （HO）, a rate-limiting enzyme in the degradation of heme to bilirubin, ferritin and carbon monoxide （ CO）. VSMC-derived CO can suppress VSMC proliferation and may serve as an antiproliferation factor. The promoter region of HO-1 shows a polymorphism with different （GT）n repeats that has been reported to differently induce gene expression. The objective of this study was to examine the effect of this variation on the occurrence of restenosis after in-stent treatment in patients with coronary artery disease. Methods Candidates who underwent coronary stent implantation were genotyped for the HO-1 promoter polymorphism using polymerase chain reaction （PCR） and automated DNA capillary sequencer. Serum levels of IL-6 and C-reactive protein （CRP） were obtained at baseline, 24 hours and 48 hours after stenting. The primary end point for the study was angiographic evidence of in-stent restenosis at 6 months. All parameters for evaluation of restenosis were analysed by quantitatve computer-assisted angiographic analysis （QCA）. Results One hundred and eighty-seven patients who underwent coronary stent implantation were studied of whom 27.8% showed 〉150% restenosis after 6 months. The distribution of （GT）n repeats of all patients in the promoter region of HO-1 genotype ranged from 22 to 42, with （GT） 25 and （GT） 32 being the two most common alleles. The allelic repeats were divided into the short class （S） with 29 （ GT）., the middle class （M） with 30- 37 （GT）n and the long class （L） with 38 （GT）n. There was no significant difference in the restenosis between the genotype groups or between post operation levels of inflammation markers, but carriers of the S allele （ n = 120） had 33.3% lower baseline IL-6 compared with non-S carriers （n =67, P =0. 0008）. Conclusions Although no association was observed between the HO-1 promoter polymorphism and coronary in-stent restenosis following the stent procedure, the association with plasma IL-6 levels suggests that HO-1 S allele might protect from the atherosclerotic inflammatory process.