Division of Cardiology, Department of Medicine, Bronx Veterans Affairs Medical Center, NY, USA.
Am J Med. 2011 Aug;124(8):724-30. doi: 10.1016/j.amjmed.2011.02.040.
PURPOSE OR BACKGROUND: Interleukin (IL)-10 is an immunoregulatory cytokine that is produced by a variety of cell types, such as macrophages and activated monocytes. IL-10 possesses numerous anti-inflammatory, anti-thrombotic and anti-atherosclerotic properties. Furthermore, patients with acute coronary syndrome have been demonstrated to have reduced levels of IL-10 compared to their stable counterparts. For these reasons, it has been proposed that IL-10 plays a protective role in both atherogenesis and plaque vulnerability. However, 2 short-term studies on the prognostic utility of IL-10 in patients with acute coronary syndrome have provided conflicting results, with one study showing that reduced levels of IL-10 were predictors of adverse outcomes and another showing that elevated levels predicted poor outcomes. The objective of the present study was to investigate the long-term prognostic significance of baseline IL-10 levels in patients with acute coronary syndrome.
Baseline plasma IL-10 levels were measured in 193 well-characterized male patients with acute coronary syndrome who were referred for coronary angiography and followed prospectively for 5 years for the development of major adverse cardiovascular events.
After controlling for a variety of baseline variables (including established biomarkers such as high-sensitivity C-reactive protein and N-terminal-pro-B-type natriuretic peptide), plasma IL-10 levels (whether analyzed as a continuous variable or as a categorical variable using receiver operating characteristic-derived cut point) were a strong and independent predictor of the composite outcome of death or non-fatal myocardial infarction when using a Cox proportional hazards model.
These data demonstrate that, despite biologic plausibility for IL-10 as being a cardioprotective cytokine, elevated baseline plasma levels of IL-10 are a strong and independent predictor of long-term adverse cardiovascular outcomes in patients with acute coronary syndrome.
白细胞介素（IL）-10 是一种免疫调节细胞因子，可由多种细胞类型产生，如巨噬细胞和激活的单核细胞。IL-10 具有许多抗炎、抗血栓和抗动脉粥样硬化的特性。此外，与稳定期患者相比，急性冠状动脉综合征患者的 IL-10 水平降低。基于这些原因，有人提出 IL-10 在动脉粥样形成和斑块易损性中均发挥保护作用。然而，两项关于 IL-10 在急性冠状动脉综合征患者中的预后价值的短期研究结果相互矛盾，一项研究表明，IL-10 水平降低是不良结局的预测因子，另一项研究表明，IL-10 水平升高预示着不良结局。本研究的目的是探讨急性冠状动脉综合征患者基线 IL-10 水平的长期预后意义。
对 193 名经特征明确的男性急性冠状动脉综合征患者进行基线血浆 IL-10 水平测量，这些患者因冠状动脉造影而被转诊，并前瞻性随访 5 年以观察主要不良心血管事件的发生。
在校正多种基线变量（包括高敏 C 反应蛋白和 N 末端 B 型利钠肽前体等已确立的生物标志物）后，使用 Cox 比例风险模型时，IL-10 水平（无论是作为连续变量还是使用接受者操作特征曲线衍生的切点作为分类变量进行分析）均为死亡或非致死性心肌梗死复合结局的强独立预测因子。
这些数据表明，尽管 IL-10 作为一种心脏保护性细胞因子具有生物学合理性，但急性冠状动脉综合征患者基线血浆 IL-10 水平升高是长期不良心血管结局的强独立预测因子。
