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CD163 阳性巨噬细胞引发的抗炎细胞因子对心肌梗死后心室功能恢复的影响。

The impact of anti-inflammatory cytokines provoked by CD163 positive macrophages on ventricular functional recovery after myocardial infarction.

机构信息

The Second Department of Internal Medicine, Toyama University Hospital, 2630 Sugitani, Toyama, 930-0194, Japan,

出版信息

J Thromb Thrombolysis. 2014;37(2):139-47. doi: 10.1007/s11239-013-0971-3.

Abstract

Present study aimed to investigate the impact of anti-inflammatory cytokines provoked by the hemoglobin scavenger receptor, CD163, on left ventricular (LV) functional recovery after successful reperfusion in patients with acute myocardial infarction (AMI). Intraplaque hemorrhage accelerates plaque destabilization. Extracellular hemoglobin is cleared by CD163, a macrophage scavenger receptor. This process provokes secretion of anti-inflammatory atheroprotective cytokine, interleukin (IL)-10. In 40 patients with the first AMI, coronary atherothrombotic debris was retrieved during percutaneous coronary intervention (PCI), stained with antibodies to CD163 and IL-10. LV function was determined by echocardiography before PCI and 6 months after PCI. %CD163 was defined as ratio of CD163 (+)-cells to whole cells. %IL-10 was expressed as the ratio of positively stained areas per total tissue. Patients were divided into two groups depending on the amount of CD163 (+)-cells: CD163 > 10 % (CD163high, n = 20) and CD163 ≤ 10 % (CD163low, n = 20). CD163high group had significantly higher %IL-10. Final thrombolysis in myocardial infarction (TIMI) flow grade was significantly lower in CD163high group. In subgroups with the final TIMI-3 flow (CD163high-Reflow, n = 15 and CD163low-Reflow, n = 20), the time to reperfusion, infarct size, LV dimensions and fractional shortening (%FS) before PCI were similar. Significant correlation was observed between %IL10 and changes in LV dimensions (diastole, r = -0.49, P = 0.01; systole, r = -0.65, P < 0.01) or %FS (r = 0.51, P < 0.01) at 6 months after PCI. Plaque with CD163(+)-macrophages could impair distal flow after primary PCI. However, CD163(+)-macrophages enhance the anti-inflammatory cytokine expression that aids in ventricular functional recovery if distal flow can be achieved by successful reperfusion.

摘要

本研究旨在探讨血红蛋白清除受体 CD163 引发的抗炎细胞因子对急性心肌梗死(AMI)患者再灌注成功后左心室(LV)功能恢复的影响。斑块内出血会加速斑块不稳定。细胞外血红蛋白通过巨噬细胞清道夫受体 CD163 清除。这一过程会引发抗炎、抗动脉粥样硬化细胞因子白细胞介素(IL)-10 的分泌。在 40 例首次发生 AMI 的患者中,在经皮冠状动脉介入治疗(PCI)期间回收了冠状动脉粥样硬化血栓碎片,并使用针对 CD163 和 IL-10 的抗体进行染色。在 PCI 前和 PCI 后 6 个月通过超声心动图确定 LV 功能。%CD163 定义为 CD163(+)细胞与总细胞的比值。%IL-10 表示阳性染色面积与总组织面积的比值。根据 CD163(+)细胞的数量将患者分为两组:CD163>10%(CD163 高,n=20)和 CD163≤10%(CD163 低,n=20)。CD163 高组的%IL-10 明显更高。CD163 高组的最终心肌梗死溶栓治疗(TIMI)血流等级明显较低。在最终 TIMI-3 血流(CD163 高再灌注亚组,n=15 和 CD163 低再灌注亚组,n=20)中,再灌注时间、梗死面积、PCI 前 LV 尺寸和射血分数(%FS)相似。%IL10 与 PCI 后 6 个月时 LV 尺寸(舒张期,r=-0.49,P=0.01;收缩期,r=-0.65,P<0.01)或%FS(r=0.51,P<0.01)的变化呈显著相关性。原发性 PCI 后,CD163(+)巨噬细胞可能会损害远端血流。然而,如果能够通过再灌注成功实现远端血流,则 CD163(+)巨噬细胞会增强抗炎细胞因子的表达,从而有助于心室功能的恢复。

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