Rechciński Tomasz, Grebowska Aneta, Kurpesa Małgorzata, Peruga Zbigniew, Dziuba Michał, Krzemińska-Pakuła Maria, Rudnicka Wiesława, Chmiela Magdalena
2nd Chair and Clinic of Cardiology, Medical University of Lodz, Lodz, Poland.
Kardiol Pol. 2007 Mar;65(3):237-44; discussion 245.
A role of CD14 receptor in the inflammatory response is stimulation of monocytes and endothelial cells by lipopolysaccharide of Gram-negative bacteria. The reports about association of progression of atherosclerosis with CD14 gene polymorphism in different populations are conflicting.
To assess if T to C exchange at position 159 of the CD14 gene correlates with age at the onset of first myocardial infarction (MI), severity of coronary atherosclerosis and number of risk factors in MI survivors in a local community characterised by high morbidity of cardiovascular diseases and whether this genotyping could be helpful in identifying patients with a high risk of MI at young age and beyond low number of risk factors.
Fifty-seven MI survivors (75.5% males) from 98 consecutive patients (pts) with coronary artery disease were included. The genotypes in position 159 of the CD14 gene were determined by polymerase chain reaction. The medical history concerning diabetes mellitus, arterial hypertension, dyslipidaemia, smoking and obesity was taken from every participant. Gensini score (GS) was calculated on the basis of coronarography. Age at first MI, value of GS and number of risk factors were analysed variables. The pts were divided into the decades of life, according to cumulated number of risk factors and into the terciles according to GS. Distribution of ages at first MI, pts with different number of risk factors and percent of pts belonging to determined terciles of GS were compared between subgroups with genotype CC and CT, TT.
The CC genotype was detected in 25 (43.8%) pts, CT in 30 (52.6%) and TT in 2 (3.6%). Age at first MI ranged from 40 to 75 years, mean 58.7+/-7.23, values of GS ranged from 0 to 154, mean 48.6+/-25.7, and number of risk factors from 0 to 4, mean 1.92+/-0.99. No significant differences in distribution of ages at first MI, values of GS or number of risk factors were found between patients with CC and with CT or TT genotype in position 159 of CD14 receptor genotype.
These data indicate that screening for CD14 159C/T polymorphism is unlikely to be a useful tool for risk assessment of MI at young age, independently of low number of risk factors, in a population with high morbidity from cardiovascular diseases.
CD14受体在炎症反应中的作用是被革兰氏阴性菌的脂多糖刺激单核细胞和内皮细胞。关于不同人群中动脉粥样硬化进展与CD14基因多态性关联的报道相互矛盾。
评估CD14基因第159位的T到C交换是否与当地社区中心血管疾病高发病率特征下心肌梗死(MI)幸存者首次心肌梗死发作时的年龄、冠状动脉粥样硬化严重程度及危险因素数量相关,以及这种基因分型是否有助于识别年轻且危险因素数量少的MI高风险患者。
纳入98例连续的冠心病患者中的57例MI幸存者(男性占75.5%)。通过聚合酶链反应确定CD14基因第159位的基因型。从每位参与者获取有关糖尿病、动脉高血压、血脂异常、吸烟和肥胖的病史。根据冠状动脉造影计算Gensini评分(GS)。首次MI时的年龄、GS值和危险因素数量为分析变量。根据危险因素累积数量将患者分为不同年龄段,根据GS分为三分位数。比较基因型为CC和CT、TT的亚组之间首次MI时的年龄分布、具有不同危险因素数量的患者以及属于GS确定三分位数的患者百分比。
25例(4,3.8%)患者检测到CC基因型,30例(52.6%)为CT,2例(3.6%)为TT。首次MI时的年龄范围为40至75岁,平均58.7±7.23,GS值范围为0至154,平均48.6±25.7,危险因素数量为0至4,平均1.92±0.99。在CD14受体基因型第159位,CC基因型与CT或TT基因型患者之间,首次MI时的年龄分布、GS值或危险因素数量均未发现显著差异。
这些数据表明,在心血管疾病高发病率人群中,筛查CD14 159C/T多态性不太可能成为独立于危险因素数量少之外用于评估年轻人MI风险的有用工具。