Jabs Wolfram J, Theissing Elisabeth, Nitschke Martin, Bechtel J F Matthias, Duchrow Michael, Mohamed Salah, Jahrbeck Bernhard, Sievers Hans-Hinrich, Steinhoff Jürgen, Bartels Claus
Department of Medicine I, University of Lübeck School of Medicine, Ratzeburger Allee 160, 23538 Lübeck, Germany.
Circulation. 2003 Sep 23;108(12):1428-31. doi: 10.1161/01.CIR.0000092184.43176.91. Epub 2003 Sep 15.
Venous coronary artery bypass grafts (CABGs) are prone to accelerated atherosclerosis. In atherosclerotic diseases, serum C-reactive protein (CRP) levels have become an important diagnostic and prognostic marker. The origin of CRP in this setting remains to be elucidated.
Monoclonal anti-CRP identified CRP expression in medial and intimal alpha-actin-positive smooth muscle cells (SMCs) of diseased CABGs with type V and VI lesions and also of native saphenous veins of atherosclerotic individuals. In addition, patent coronary arteries with type IV and V but not with type I through III lesions exhibited intense SMC staining for CRP. Calcified desobliterates of occluded coronary arteries with end-stage disease did not show SMC staining for CRP and were consistently negative for CRP mRNA, as detected by means of real-time polymerase chain reaction. However, CRP mRNA was expressed in 11 of 15 diseased CABGs and also in 10 of 15 native veins. By contrast, only 3 of 18 internal mammary and 4 of 12 radial arteries with virtually no atherosclerosis were positive for CRP mRNA.
CRP is produced by SMCs of atherosclerotic lesions with active disease but not in end-stage plaques. The role of CRP constitutively expressed by normal vascular tissue in vein graft disease has yet to be elucidated.
静脉冠状动脉旁路移植血管（CABG）易于发生动脉粥样硬化加速。在动脉粥样硬化疾病中，血清C反应蛋白（CRP）水平已成为重要的诊断和预后标志物。在这种情况下，CRP的来源仍有待阐明。
单克隆抗CRP抗体在患有V型和VI型病变的病变CABG以及动脉粥样硬化个体的大隐静脉的中膜和内膜α-肌动蛋白阳性平滑肌细胞（SMC）中鉴定出CRP表达。此外，具有IV型和V型病变但不具有I型至III型病变的通畅冠状动脉显示出强烈的SMC对CRP的染色。患有终末期疾病的闭塞冠状动脉的钙化再通血管未显示SMC对CRP的染色，并且通过实时聚合酶链反应检测，其CRP mRNA始终为阴性。然而，15个病变CABG中有11个以及15个天然静脉中有10个表达CRP mRNA。相比之下，18个几乎没有动脉粥样硬化的乳内动脉中有3个以及12个桡动脉中有4个CRP mRNA呈阳性。
CRP由患有活动性疾病的动脉粥样硬化病变的SMC产生，而不是在终末期斑块中产生。正常血管组织组成性表达的CRP在静脉移植血管疾病中的作用尚待阐明。
