Shiraki Rio, Inoue Nobutaka, Kobayashi Seiichi, Ejiri Junya, Otsui Kazunori, Honjo Tomoyuki, Takahashi Motonori, Hirata Ken-ichi, Yokoyama Mitsuhiro, Kawashima Seinosuke
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Life Sci. 2006 Dec 3;80(1):59-66. doi: 10.1016/j.lfs.2006.08.027. Epub 2006 Sep 6.
Toll-like receptors (TLRs) play important roles in the pathogenesis of atherosclerosis. On the other hand, serum high sensitivity C-reactive protein (hsCRP) is known as an independent coronary risk factor, but cardiovascular events do occur even in low hsCRP levels. We investigated whether the TLR4 expression levels on human peripheral blood monocytes were associated with serum hsCRP levels or the occurrence of coronary artery diseases (CAD). One hundred CAD patients and 100 non-CAD subjects were enrolled. There were 72 non-CAD subjects and 53 CAD patients with low serum hsCRP levels. Among the low-hsCRP subjects, the TLR4 expression levels were higher in CAD patients than in non-CAD subjects (P < 0.05, after being adjusted for other risk factors). Moreover, TLR4 expression levels in stable angina pectoris (SAP) patients were elevated compared with those in non-CAD subjects (P < 0.05), and those in acute coronary syndrome patients were higher than SAP patients even in low-hsCRP subjects (P < 0.01). In conclusion, the TLR4 expression levels on peripheral blood monocytes in CAD patients were higher than those in non-CAD subjects and correlated with disease activity, even in low-hsCRP subjects. The combined measurement of serum hsCRP and the TLR4 expression on peripheral blood monocytes, especially among low-hsCRP subjects, may become a new coronary risk marker.
Toll样受体（TLRs）在动脉粥样硬化的发病机制中起重要作用。另一方面，血清高敏C反应蛋白（hsCRP）是一种独立的冠心病危险因素，但即使在hsCRP水平较低时也会发生心血管事件。我们研究了人类外周血单核细胞上TLR4的表达水平是否与血清hsCRP水平或冠状动脉疾病（CAD）的发生有关。纳入了100例CAD患者和100例非CAD受试者。有72例非CAD受试者和53例血清hsCRP水平较低的CAD患者。在低hsCRP受试者中，CAD患者的TLR4表达水平高于非CAD受试者（在调整其他危险因素后，P < 0.05）。此外，稳定型心绞痛（SAP）患者的TLR4表达水平高于非CAD受试者（P < 0.05），即使在低hsCRP受试者中，急性冠状动脉综合征患者的TLR4表达水平也高于SAP患者（P < 0.01）。总之，CAD患者外周血单核细胞上的TLR4表达水平高于非CAD受试者，并且与疾病活动相关，即使在低hsCRP受试者中也是如此。血清hsCRP与外周血单核细胞上TLR4表达的联合检测，尤其是在低hsCRP受试者中，可能成为一种新的冠心病风险标志物。
