Szkodzinski J, Blazelonis A, Wilczek K, Hudzik B, Romanowski W, Gasior M, Wojnar R, Lekston A, Polonski L, Zubelewicz-Szkodzinska B
3rd Dept. of Cardiology, Silesian Medical University, Zabrze, Poland.
Int J Immunopathol Pharmacol. 2009 Apr-Jun;22(2):493-500. doi: 10.1177/039463200902200226.
Despite high efficacy of percutaneous coronary intervention (PCI), in-stent restenosis proves to be a significant problem of therapy. Restenosis concerns around 30 percent of patients. Studies have suggested that restenosis is initiated by cells which participate in intense inflammatory reaction caused by stent implantation. Atherosclerotic plaque rupture during stent implantation and PCI-associated injury of the vessel wall lead to hemorrhage and release of various cytokines. They are probably responsible for quick recurrence of vascular lumen stenosis (restenosis). Interleukin-6 (IL-6) is known as a main pro-inflammatory cytokine, whereas Transformig Growth Factor-beta1 (TGF-beta1) has anti-inflammatory properties. The study population comprised 36 patients with myocardial infarction treated with PCI with stent implantation. They underwent control coronary angiography after 12 months. At this time plasma concentration of IL-6 and TGF-beta was measured in peripheral blood. Serum IL-6 concentration in the analyzed population correlates with lumen loss (p<0.01) and the severity of stenosis (p<0.001). No such correlation was found between serum TGF-beta1 concentration and lumen loss (p=NS) or the severity of stenosis (p=NS). The IL-6 plasma concentration may be a marker of in-stent restenosis in patients after PTCA, while the concentration of TGF-beta1 is not associated with the occurrence of restenosis at one year of follow-up.
尽管经皮冠状动脉介入治疗(PCI)疗效显著,但支架内再狭窄仍是治疗中的一个重大问题。约30%的患者会出现再狭窄。研究表明,再狭窄是由参与支架植入引起的强烈炎症反应的细胞引发的。支架植入过程中动脉粥样硬化斑块破裂以及PCI相关的血管壁损伤会导致出血和多种细胞因子的释放。它们可能是血管腔狭窄(再狭窄)快速复发的原因。白细胞介素-6(IL-6)是一种主要的促炎细胞因子,而转化生长因子-β1(TGF-β1)具有抗炎特性。研究对象包括36例接受PCI并植入支架治疗的心肌梗死患者。他们在12个月后接受了冠状动脉造影检查。此时检测外周血中IL-6和TGF-β的血浆浓度。分析人群中血清IL-6浓度与管腔丢失(p<0.01)和狭窄严重程度(p<0.001)相关。血清TGF-β1浓度与管腔丢失(p=无显著性差异)或狭窄严重程度(p=无显著性差异)之间未发现此类相关性。IL-6血浆浓度可能是PTCA术后患者支架内再狭窄的一个标志物,而TGF-β1浓度与随访一年时再狭窄的发生无关。