Kayo Soichiro, Ohsawa Masahiko, Ehara Shoichi, Naruko Takahiko, Ikura Yoshihiro, Hai Eishu, Yoshimi Noriko, Shirai Nobuyuki, Tsukamoto Yoshiaki, Itabe Hiroyuki, Higuchi Kazuhide, Arakawa Tetsuo, Ueda Makiko
Department of Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Am Heart J. 2004 Nov;148(5):818-25. doi: 10.1016/j.ahj.2004.05.042.
Oxidized low-density lipoprotein (ox-LDL) is a key factor in the progression of atherosclerosis. We developed a sensitive method for measuring plasma ox-LDL levels using a novel anti-ox-LDL antibody. Recently, several studies have shown positive associations between Helicobacter pylori (H pylori) infection and coronary heart disease. Thus the question arises whether an increase in the plasma levels of ox-LDL occurs in patients with H pylori gastritis.
We measured plasma ox-LDL levels in patients with H pylori gastritis (n = 27) and compared them with those in patients with acute myocardial infarction (AMI) (n = 62) and stable angina pectoris (SAP; n = 63) and those in control subjects (n = 64). In addition, ox-LDL localization and the presence of macrophages and neutrophils were studied immunohistochemically in gastritis specimens and in coronary culprit lesions obtained from patients with AMI.
Plasma ox-LDL levels in patients with AMI were significantly higher than those in patients with SAP (P <.0001), patients with H pylori gastritis (P <.0001), or in control subjects (P <.0001; AMI, 1.34 +/- 0.95; SAP, 0.61 +/- 0.29; Gastritis, 0.53 +/- 0.17; control, 0.57 +/- 0.23 ng/5 microg LDL protein). Immunohistochemically, H pylori gastritis specimens showed distinct infiltration of macrophages and myeloperoxidase-positive neutrophils; however, ox-LDL localization was not detected. In contrast, coronary culprit plaques revealed strong positivity for ox-LDL in ruptured lipid cores with abundant macrophage-derived foam cells, and these plaques also contained myeloperoxidase-positive neutrophils.
Our results suggest that plasma ox-LDL levels do not seem to be associated with H pylori infection, but do relate to coronary plaque instability in AMI.
氧化型低密度脂蛋白(ox-LDL)是动脉粥样硬化进展的关键因素。我们利用一种新型抗ox-LDL抗体开发了一种测量血浆ox-LDL水平的灵敏方法。最近,多项研究表明幽门螺杆菌(H pylori)感染与冠心病之间存在正相关。因此,问题在于幽门螺杆菌胃炎患者的血浆ox-LDL水平是否会升高。
我们测量了幽门螺杆菌胃炎患者(n = 27)的血浆ox-LDL水平,并将其与急性心肌梗死(AMI)患者(n = 62)、稳定型心绞痛(SAP;n = 63)患者以及对照受试者(n = 64)的血浆ox-LDL水平进行比较。此外,采用免疫组织化学方法研究了胃炎标本以及AMI患者冠状动脉罪犯病变中ox-LDL的定位情况,以及巨噬细胞和中性粒细胞的存在情况。
AMI患者的血浆ox-LDL水平显著高于SAP患者(P <.0001)、幽门螺杆菌胃炎患者(P <.0001)或对照受试者(P <.0001;AMI,1.34 ± 0.95;SAP,0.61 ± 0.29;胃炎,0.53 ± 0.17;对照,0.57 ± 0.23 ng/5 μg LDL蛋白)。免疫组织化学结果显示,幽门螺杆菌胃炎标本中有明显的巨噬细胞浸润以及髓过氧化物酶阳性的中性粒细胞;然而,未检测到ox-LDL的定位。相比之下,冠状动脉罪犯斑块在富含巨噬细胞衍生泡沫细胞的破裂脂质核心中显示出ox-LDL强阳性,并且这些斑块中也含有髓过氧化物酶阳性的中性粒细胞。
我们的结果表明,血浆ox-LDL水平似乎与幽门螺杆菌感染无关,但与AMI中的冠状动脉斑块不稳定性有关。