Miranda-Malpica Emma, Martínez-Rios Marco Antonio, Fragoso José Manuel, Delgadillo-Rodríguez Hilda, Rodríguez-Pérez José Manuel, González-Quesada Carlos, Martínez-Rodríguez Nancy, Saldaña-Mendoza Arturo, Peña-Duque Marco Antonio, Vargas-Alarcón Gilberto
Interventional Cardiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
Hum Immunol. 2008 Feb;69(2):116-21. doi: 10.1016/j.humimm.2007.12.003. Epub 2008 Jan 22.
Inflammation is the primary response to vessel wall injury caused by stent placement in coronary arteries. Cytokines of the interleukin-1 family are central regulators in immunoinflammatory mechanisms. The objective of this study was to test for association between IL-1 family gene polymorphisms and risk for restenosis after coronary stent placement. The IL-1B-511, IL-1F10.3, RN.4T>C, RN.6/1C>T, RN.6/2C>G, and IL-1RN VNTR polymorphisms were analyzed by 5' exonuclease TaqMan genotyping assays and polymerase chain reaction in a group of 165 patients who underwent coronary artery stenting. Basal and procedure coronary angiography were analyzed in search of angiographic predictors of restenosis and follow-up angiography was analyzed in search of binary restenosis. Patients with IL-1B-511 TT genotype had a 1.89-fold increased risk of developing restenosis. The analysis considering the lesions treated demonstrated that the lesions of patients with IL-1B-511 TT genotype had a 3.44-fold increased risk of developing restenosis. When the analysis considered the type of stent, the risk of developing restenosis was increased in lesions of patients with TT genotype (odds ratio = 4.50) who underwent coronary bare-metal stent implantation. Multiple logistic analysis identified IL-1B-511 TT genotype as an independent predictor for restenosis. The results suggest that IL-1B-511 polymorphism could be involved in the risk of developing restenosis after coronary stent placement.
炎症是冠状动脉支架置入引起血管壁损伤的主要反应。白细胞介素-1家族的细胞因子是免疫炎症机制的核心调节因子。本研究的目的是检测白细胞介素-1家族基因多态性与冠状动脉支架置入术后再狭窄风险之间的关联。通过5'核酸外切酶TaqMan基因分型检测和聚合酶链反应,对165例行冠状动脉支架置入术的患者进行白细胞介素-1β -511、白细胞介素-1F10.3、RN.4T>C、RN.6/1C>T、RN.6/2C>G和白细胞介素-1受体拮抗剂可变数目串联重复序列多态性分析。分析基础和术中冠状动脉造影以寻找再狭窄的血管造影预测因素,并分析随访血管造影以寻找二元再狭窄。白细胞介素-1β -511 TT基因型患者发生再狭窄的风险增加1.89倍。考虑所治疗病变的分析表明,白细胞介素-1β -511 TT基因型患者的病变发生再狭窄的风险增加3.44倍。当分析考虑支架类型时,接受冠状动脉裸金属支架植入的TT基因型患者的病变发生再狭窄的风险增加(优势比=4.50)。多因素逻辑分析确定白细胞介素-1β -511 TT基因型是再狭窄的独立预测因素。结果表明,白细胞介素-1β -511多态性可能与冠状动脉支架置入术后再狭窄风险有关。