Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
J Atheroscler Thromb. 2010 Nov 27;17(11):1115-21. doi: 10.5551/jat.4606. Epub 2010 Aug 5.
Inflammation plays a key role in atherosclerosis and plaque vulnerability, and monocyte/macrophage activation contributes to these processes. Neopterin, a by-product of the guanosine triphosphate pathway, is produced by activated macrophages on stimulation with interferon-γ released from T lymphocytes, and is an activation marker for monocytes/macrophages. Coronary angiographic studies have shown a relationship between increased circulating levels of neopterin and the presence of complex coronary lesions in patients with unstable angina pectoris (UAP). Furthermore, in an immunohistochemical study performed using coronary atherectomy specimens, a significantly higher prevalence of neopterin-positive macrophages was found in culprit lesions in patients with UAP than in those with stable angina pectoris (SAP). We recently clarified that the presence of complex carotid plaques detected by carotid ultrasound was related to increased circulating levels of neopterin, and immunohistochemical localization of neopterin was observed in complex carotid lesions obtained from carotid endarterectomy in patients with SAP. These findings suggest that neopterin is an important biomarker of plaque instability in both coronary and carotid atherosclerotic lesions.
炎症在动脉粥样硬化和斑块易损性中起关键作用,单核细胞/巨噬细胞的激活促进了这些过程。新蝶呤是三磷酸鸟苷途径的副产物,在受到 T 淋巴细胞释放的干扰素-γ刺激后,由激活的巨噬细胞产生,是单核细胞/巨噬细胞的激活标志物。冠状动脉造影研究表明,不稳定型心绞痛(UAP)患者循环中新蝶呤水平升高与复杂冠状动脉病变的存在之间存在关系。此外,在使用冠状动脉内膜切除术标本进行的免疫组织化学研究中,与稳定型心绞痛(SAP)患者相比,UAP 患者的罪犯病变中发现新蝶呤阳性巨噬细胞的比例明显更高。我们最近阐明,颈动脉超声检测到的复杂颈动脉斑块的存在与循环中新蝶呤水平升高有关,并且在 SAP 患者颈动脉内膜切除术中获得的复杂颈动脉病变中观察到新蝶呤的免疫组织化学定位。这些发现表明,新蝶呤是冠状动脉和颈动脉粥样硬化病变中斑块不稳定性的重要生物标志物。