Netea M G, Hijmans A, van Wissen S, Smilde T J, Trip M D, Kullberg B J, de Boo T, Van der Meer J W M, Kastelein J J P, Stalenhoef A F H
University Medical Center, St. Radboud, Nijmegen, The Netherlands.
Eur J Clin Invest. 2004 Feb;34(2):94-9. doi: 10.1111/j.1365-2362.2004.01303.x.
Toll-like receptor-4 (TLR4) is a major receptor for inflammatory stimuli potentially involved in the pathogenesis of atherosclerosis, such as lipopolysaccharide (LPS) and heat-shock proteins. The Asp299Gly polymorphism of the TLR4 gene has been associated with a reduced intima-media thickness (IMT) of the common carotid artery in healthy individuals. We have investigated whether the presence of the Asp299Gly polymorphism in patients with familial hypercholesterolaemia (FH) has a similar protective effect, and whether it influences the effects of HMG-CoA reductase treatment.
A cohort of 293 FH patients and 200 healthy volunteers were genotyped for the presence of the Asp299Gly allele using polymerase chain reaction followed by restriction fragment length polymorphism analysis. Intima-media thickness measurements, inflammatory parameters and the effect of HMG-CoA reductase inhibitors were compared between the patients with and without Asp299Gly allele.
The Asp299Gly allele was present in 10.6% of the FH patients and 11.0% of the healthy individuals. Whereas the FH patients carrying the Asp299Gly allele displayed a reduced absolute IMT value compared with the FH patients carrying the wild-type allelle, the difference did not reach statistical significance. In addition, the effect of treatment with HMG-CoA reductase inhibitors was not influenced by the presence of Asp299Gly allele.
The presence of the Asp299Gly allele of the TLR4 gene does not seem to exert a major influence on the progression of atherosclerosis in patients with FH.
Toll样受体4(TLR4)是炎症刺激的主要受体,可能参与动脉粥样硬化的发病机制,如脂多糖(LPS)和热休克蛋白。TLR4基因的Asp299Gly多态性与健康个体颈总动脉内膜中层厚度(IMT)降低有关。我们研究了家族性高胆固醇血症(FH)患者中Asp299Gly多态性的存在是否具有类似的保护作用,以及它是否会影响HMG-CoA还原酶治疗的效果。
采用聚合酶链反应随后进行限制性片段长度多态性分析,对293例FH患者和200名健康志愿者进行Asp299Gly等位基因分型。比较有无Asp299Gly等位基因的患者之间的内膜中层厚度测量值、炎症参数以及HMG-CoA还原酶抑制剂的效果。
10.6%的FH患者和11.0%的健康个体存在Asp299Gly等位基因。与携带野生型等位基因的FH患者相比,携带Asp299Gly等位基因的FH患者的绝对IMT值降低,但差异未达到统计学意义。此外,HMG-CoA还原酶抑制剂的治疗效果不受Asp299Gly等位基因存在的影响。
TLR4基因Asp299Gly等位基因的存在似乎对FH患者动脉粥样硬化的进展没有重大影响。