Brountzos Elias N, Tavernaraki Kyriaki, Gouliamos Athanasios D, Degiannis Dimitrios, Chaidaroglou Antigoni, Panagiotou Irene, Arsenis George, Kelekis Dimitrios, Vlahakos Demetrios
Second Department of Radiology, Athens University Medical School, Attikon University Hospital, Chaidari, Athens, Greece.
J Vasc Interv Radiol. 2009 Feb;20(2):186-91. doi: 10.1016/j.jvir.2008.10.024. Epub 2008 Dec 12.
Time changes in plasma concentrations of six different cytokines were investigated to evaluate the inflammatory response to renal artery stent placement.
A total of 22 patients (17 men; mean age, 66 years +/- 13) with ostial renal artery stenosis and poorly controlled hypertension treated with stent placement were studied. Blood samples were collected at baseline and at 24 hours and 6 months after the intervention. Plasma concentrations of (i) tumor necrosis factor-alpha, (ii) interleukin-6 (IL-6), (iii) monocyte chemoattractant protein-1, (iv) intercellular adhesion molecule-1, (v) vascular cell adhesion molecule-1, and (vi) regulated upon activatin normal T-cell expressed presumed secreted were measured. Restenosis diagnosed with imaging follow-up at 6 months was recorded. Plasma concentrations of the aforementioned cytokines were compared between patients with and without restenosis.
IL-6 concentration increased significantly 24 hours after stent placement (8.3 pg/mL +/- 1.24 vs. 2.76 pg/mL +/- 1.27 at baseline) and returned to baseline levels (2.6 pg/mL +/- 1.77) at 6-month follow-up (P < .0001). No significant changes occurred in the concentrations of any other cytokines at the three time points. Baseline and 6-month concentrations of IL-6 were significantly higher in patients with restenosis than in those without restenosis (8.13 pg/mL +/- 4 vs 0.75 pg/mL +/- 0.47 [P < .005] and 9.55 pg/mL +/- 6.5 vs 0.42 pg/mL +/- 0.35 [P < .02], respectively).
Renal artery angioplasty with stent placement induces an inflammatory response, as evidenced by increased IL-6 production. Additionally, IL-6 seems to identify patients prone to develop restenosis; therefore, it might be used as an early predictor of restenosis after renal angioplasty with stent placement. However, larger studies are required to confirm IL-6 as a potential predictor of restenosis.
研究六种不同细胞因子血浆浓度随时间的变化，以评估肾动脉支架置入术后的炎症反应。
共研究了22例患有肾动脉开口狭窄且高血压控制不佳并接受支架置入治疗的患者（17例男性；平均年龄66岁±13岁）。在基线、干预后24小时和6个月时采集血样。测量了以下六种细胞因子的血浆浓度：（i）肿瘤坏死因子-α、（ii）白细胞介素-6（IL-6）、（iii）单核细胞趋化蛋白-1、（iv）细胞间黏附分子-1、（v）血管细胞黏附分子-1以及（vi）活化正常T细胞表达和分泌的调节因子。记录6个月时通过影像学随访诊断的再狭窄情况。比较了有再狭窄和无再狭窄患者上述细胞因子的血浆浓度。
支架置入后24小时IL-6浓度显著升高（8.3 pg/mL±1.24，而基线时为2.76 pg/mL±1.27），并在6个月随访时恢复至基线水平（2.6 pg/mL±1.77）（P <.0001）。在这三个时间点，其他任何细胞因子的浓度均未发生显著变化。有再狭窄患者的IL-6基线浓度和6个月浓度显著高于无再狭窄患者（分别为8.13 pg/mL±4与0.75 pg/mL±0.47 [P <.005]以及9.55 pg/mL±6.5与0.42 pg/mL±0.35 [P <.02]）。
肾动脉血管成形术联合支架置入可引发炎症反应，IL-6产生增加即为证据。此外，IL-6似乎可识别易发生再狭窄的患者；因此，它可能用作肾动脉血管成形术联合支架置入术后再狭窄的早期预测指标。然而，需要更大规模的研究来证实IL-6作为再狭窄潜在预测指标的作用。
