Department of Pathology, College of Medicine, University of Saskatchewan, and Royal University Hospital, Saskatoon, Saskatchewan, Canada.
Clin Cardiol. 2010 Nov;33(11):678-85. doi: 10.1002/clc.20815.
Interaction of advanced glycation end products (AGEs) with their receptor (RAGE) increases expression of inflammatory mediators (tumor necrosis factor alpha [TNF-α] and soluble vascular cell adhesion molecule-1 [sVCAM-1]) and induces oxygen radicals that are implicated in atherosclerosis. Balloon-injury-induced atherosclerosis is associated with increased expression of AGEs and RAGE. The soluble receptor for AGE (sRAGE), which acts as a decoy for RAGE ligands (AGEs), prevents atherosclerosis in this model.
We evaluated: 1) whether post-percutaneous coronary intervention (PCI) restenosis is associated with low pre-PCI serum sRAGE, high serum AGEs, TNF-α, and sVCAM-1, and high AGE/sRAGE ratio; 2) whether pre-PCI and post-PCI levels of these markers are similar in patients with or without restenosis; and 3) whether sRAGE and AGE/sRAGE ratio have predictive value for post-PCI restenosis.
Angiography was performed in 46 patients with non-ST-segment elevation myocardial infarction for assessment of restenosis. Serum sRAGE, AGEs, TNF-α, and sVCAM-1 were measured in these patients and 20 control subjects.
: Nineteen of the 46 patients developed post-PCI restenosis, which was associated with lower sRAGE and higher TNF-α and sVCAM-1 levels, and higher AGE/sRAGE ratio compared with patients without restenosis. Pre-PCI and post-PCI levels of these biomarkers were similar in both groups, except in patients with restenosis, in whom the post-PCI level of sRAGE was lower and TNF-α was higher than the pre-PCI levels. The sensitivity and negative predictive value of sRAGE were 100%, and were higher than those of AGE/sRAGE ratio in identifying post-PCI restenosis.
Both low serum sRAGE levels and high AGE/sRAGE ratio have predictive value for post-PCI restenosis.
晚期糖基化终产物（AGEs）与其受体（RAGE）的相互作用会增加炎症介质（肿瘤坏死因子-α[TNF-α]和可溶性血管细胞黏附分子-1[sVCAM-1]）的表达，并诱导与动脉粥样硬化有关的氧自由基。球囊损伤诱导的动脉粥样硬化与 AGEs 和 RAGE 表达增加有关。AGE 的可溶性受体（sRAGE）作为 RAGE 配体（AGEs）的诱饵，可防止该模型中的动脉粥样硬化。
我们评估了：1）经皮冠状动脉介入治疗（PCI）后再狭窄是否与低 PCI 前血清 sRAGE、高血清 AGEs、TNF-α 和 sVCAM-1 以及高 AGE/sRAGE 比值相关；2）在有或没有再狭窄的患者中，PCI 前后这些标志物的水平是否相似；3）sRAGE 和 AGE/sRAGE 比值对 PCI 后再狭窄是否具有预测价值。
对 46 例非 ST 段抬高型心肌梗死患者进行血管造影以评估再狭窄情况。对这些患者和 20 名对照者进行血清 sRAGE、AGEs、TNF-α 和 sVCAM-1 检测。
46 例患者中有 19 例发生 PCI 后再狭窄，与无再狭窄患者相比，sRAGE 水平较低，TNF-α 和 sVCAM-1 水平较高，AGE/sRAGE 比值较高。两组患者的 PCI 前后这些生物标志物的水平相似，除了再狭窄患者的 sRAGE 水平较 PCI 前降低，TNF-α 水平较 PCI 前升高。sRAGE 的灵敏度和阴性预测值均为 100%，在识别 PCI 后再狭窄方面高于 AGE/sRAGE 比值。
血清 sRAGE 水平较低和 AGE/sRAGE 比值较高均对 PCI 后再狭窄具有预测价值。
