Meuwese Marijn C, Trip Mieke D, van Wissen Sanne, van Miert Joram N I, Kastelein John J P, Stroes Erik S G
Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
Atherosclerosis. 2008 Apr;197(2):916-21. doi: 10.1016/j.atherosclerosis.2007.08.011. Epub 2007 Sep 17.
Myeloperoxidase (MPO), an antimicrobial enzyme of the innate immune system, has been proposed to exert a wide array of pro-atherogenic effects throughout all stages of the atherosclerotic process. In view of the potent anti-inflammatory effects of statins in vitro, we evaluated the impact of statin therapy on plasma MPO levels in patients with heterozygous familial hypercholesterolemia (FH), treated with either intensive or conventional lipid-lowering therapy. Furthermore, we evaluated the relation between MPO levels and atherosclerosis progression, as determined by intima media thickness (IMT).
We measured plasma MPO levels, lipoprotein profiles, high sensitivity-C-reactive protein (hs-CRP) as well as IMT of carotid artery segments in 122 FH patients at baseline and after 2-year treatment with atorvastatin 80 mg or simvastatin 40 mg QD.
Baseline median MPO values were 147pM (interquartile range (IQR) 122-217) and 144pM (IQR 118-216) and these increased significantly to 221pM (IQR 144-290) and 255pM (IQR 152-324) during 2-year follow-up in both the atorvastatin 80 mg and simvastatin 40 mg group, respectively. There was no correlation between MPO levels and IMT progression, change in lipoproteins or hs-CRP.
In FH patients, statins do not prevent an increase in MPO levels during follow-up. Moreover, MPO levels are not associated with atherosclerosis progression in these patients.
髓过氧化物酶（MPO）是一种先天性免疫系统的抗菌酶，有人提出它在动脉粥样硬化过程的各个阶段都发挥着广泛的促动脉粥样硬化作用。鉴于他汀类药物在体外具有强大的抗炎作用，我们评估了他汀类药物治疗对杂合子家族性高胆固醇血症（FH）患者血浆MPO水平的影响，这些患者接受了强化或常规降脂治疗。此外，我们评估了MPO水平与动脉粥样硬化进展之间的关系，动脉粥样硬化进展通过内膜中层厚度（IMT）来确定。
我们测量了122例FH患者在基线时以及接受阿托伐他汀80mg或辛伐他汀40mg每日一次治疗2年后的血浆MPO水平、脂蛋白谱、高敏C反应蛋白（hs-CRP）以及颈动脉段的IMT。
基线时MPO的中位数分别为147pM（四分位间距（IQR）122 - 217）和144pM（IQR 118 - 216），在阿托伐他汀80mg组和辛伐他汀40mg组的2年随访期间，分别显著升高至221pM（IQR 144 - 290）和255pM（IQR 152 - 324）。MPO水平与IMT进展、脂蛋白变化或hs-CRP之间无相关性。
在FH患者中，他汀类药物不能预防随访期间MPO水平的升高。此外，这些患者的MPO水平与动脉粥样硬化进展无关。
