Rechciński Tomasz, Grebowska Aneta, Kurpesa Małgorzata, Sztybrych Marta, Peruga Jan Z, Trzos Ewa, Rudnicka Wiesława, Krzemińska-Pakuła Maria, Chmiela Magdalena
II Katedra i Klinika Kardiologii, Uniwersytet Medyczny, ul. Kniaziewicza 1/5, 91-347 Łódź, Poland.
Kardiol Pol. 2009 Jun;67(6):601-10.
Pro-inflammatory cytokine interleukin-1b (IL-1b) plays a role in atherosclerosis. The results of several studies on the association between polymorphism of the IL-1b gene cluster and the course of coronary atherosclerosis have been inconclusive.
To investigate retrospectively whether the patients with the most common variants of polymorphism of the IL-1b gene cluster differ with respect to localisation and extent of coronary atherosclerosis to a degree which may influence the treatment strategy.
Ninety-two consecutive out-patients (age 39-83, male sex 74%) with coronary artery disease confirmed by angiography were included. In this group, 23 patients underwent coronary artery bypass grafting (CABG) and 69 percutaneous coronary interventions (PCI) of whom in 16 repeated treatment was performed. The polymorphisms of the IL-1b gene - transition C/T at -511 and -31 position - as well as of the IL-1 receptor antagonist gene (IL-1RN) - an 86-base pair variable-number tandem repeat in intron 2 - were determined by PCR. Out of the 54 theoretically possible combinations of polymorphisms, 17 were found in the studied group. The three most common combinations of polymorphisms were selected. The fraction of patients treated by means of primary or elective percutaneous coronary intervention (pPCI, ePCI) and by means of CABG were compared between the subgroups with one of the 3 most common combinations of polymorphisms.
The most frequent combinations of polymorphisms were - Variant A: -31 C/T, -511C/T, RN 1/1 - 32.6%; Variant B: -31T/T, -511C/C, RN 1/1 - 27.1%; Variant C: -31C/T, -11C/T, RN 1/2 - 10.8%. The remaining patients (29.5%) represented 14 variants present in very small subgroups consisting only of 1, 2 or 3 persons. Statistical analysis showed that patients with the second most common variant of studied polymorphisms (variant B) were significantly more frequently treated with CABG in comparison to the two other variants. Also, repeated PCI was most frequent in this subgroup.
The data presented here suggest that carriers of the two relatively frequent variants of the IL-1b gene at -31 and -511 position, i.e. -31TT and -511CC, are at a higher risk of developing coronary artery disease requiring surgical treatment or two-stage percutaneous angioplasty.
促炎细胞因子白细胞介素-1β（IL-1β）在动脉粥样硬化中起作用。关于IL-1β基因簇多态性与冠状动脉粥样硬化病程之间关联的多项研究结果尚无定论。
回顾性研究IL-1β基因簇多态性最常见变体的患者在冠状动脉粥样硬化的定位和程度方面是否存在差异，其差异程度可能会影响治疗策略。
纳入92例经血管造影确诊为冠心病的连续门诊患者（年龄39 - 83岁，男性占74%）。该组中，23例行冠状动脉旁路移植术（CABG），69例行经皮冠状动脉介入治疗（PCI），其中16例接受了重复治疗。通过聚合酶链反应（PCR）测定IL-1β基因在 - 511和 - 31位置的C/T转换多态性以及IL-1受体拮抗剂基因（IL-1RN）内含子2中86个碱基对的可变数目串联重复多态性。在所研究的54种理论上可能的多态性组合中，该组中发现了17种。选取了三种最常见的多态性组合。比较了具有三种最常见多态性组合之一的亚组中接受初次或择期经皮冠状动脉介入治疗（pPCI，ePCI）以及接受CABG治疗的患者比例。
最常见的多态性组合为 - 变体A： - 31C/T， - 511C/T，RN 1/1 - 32.6%；变体B： - 31T/T， - 511C/C，RN 1/1 - 27.1%；变体C： - 31C/T， - 11C/T，RN 1/2 - 10.8%。其余患者（29.5%）代表14种变体，存在于仅由1、2或3人组成的非常小的亚组中。统计分析表明，与其他两种变体相比，具有研究的多态性第二常见变体（变体B）的患者接受CABG治疗的频率明显更高。此外，该亚组中重复PCI也最为频繁。
此处呈现的数据表明，IL-1β基因在 - 31和 - 511位置的两种相对常见变体的携带者，即 - 31TT和 - 511CC，发生需要手术治疗或两阶段经皮血管成形术的冠状动脉疾病的风险更高。
