Wypasek Ewa, Potaczek Daniel P, Lamplmayr Markus, Sadowski Jerzy, Undas Anetta
Clin Chem Lab Med. 2014 Jul;52(7):1049-56. doi: 10.1515/cclm-2013-0606.
Interleukin-6 receptor (IL-6R) gene Asp358Ala (A>C, rs2228145) polymorphism has been associated with lower circulating inflammation biomarkers in coronary artery disease (CAD), such as C-reactive protein (CRP) or fibrinogen, but its role in the pathogenesis of aortic valve stenosis (AS) remains unknown. Since the pathogenesis of AS and atherosclerosis shares several similarities, we tested the hypothesis that IL-6R Asp358Ala polymorphism is associated with the severity of AS.
A total of 284 AS patients aged 64.3±11.1 years were studied, in whom IL-6R polymorphism was determined by TaqMan genotyping.
The genotype distribution was as follows: AA-43.7% (n=124); AC-37.0% (n=105); and CC-19.4% (n=55). For every copy of C allele inherited, mean concentration of CRP was reduced by 22% (95% CI 13.8-30.4; p<0.0001). Carriers of the C allele compared to the AA homozygotes were also characterized by lower mean and maximal transvalvular gradients [44.8 (30.5-60.0) vs. 52.7 (40.5-69.0) mmHg, p=0.0005; and 78.1±26.5 vs. 87.3±27.6 mmHg; p=0.008, respectively], and larger aortic valve area [0.8 (0.6-1.0) vs. 0.7 (0.5-0.9) cm2, p=0.005].
Our study is the first to show that the presence of the IL-6R 358Ala allele in AS patients is associated with attenuated systemic inflammatory state and less severe AS.
白细胞介素-6受体(IL-6R)基因Asp358Ala(A>C,rs2228145)多态性与冠状动脉疾病(CAD)中较低的循环炎症生物标志物相关,如C反应蛋白(CRP)或纤维蛋白原,但其在主动脉瓣狭窄(AS)发病机制中的作用尚不清楚。由于AS和动脉粥样硬化的发病机制有若干相似之处,我们检验了IL-6R Asp358Ala多态性与AS严重程度相关的假设。
共研究了284例年龄为64.3±11.1岁的AS患者,通过TaqMan基因分型确定IL-6R多态性。
基因型分布如下:AA-43.7%(n = 124);AC-37.0%(n = 105);CC-19.4%(n = 55)。每遗传一份C等位基因,CRP的平均浓度降低22%(95%CI 13.8 - 30.4;p<0.0001)。与AA纯合子相比,C等位基因携带者的平均和最大跨瓣压差也较低[44.8(30.5 - 60.0)与52.7(40.5 - 69.0)mmHg,p = 0.0005;以及78.1±26.5与87.3±27.6 mmHg;p = 0.008],主动脉瓣面积较大[0.8(0.6 - 1.0)与0.7(0.5 - 0.9)cm2,p = 0.005]。
我们的研究首次表明,AS患者中IL-6R 358Ala等位基因的存在与全身炎症状态减轻和AS病情较轻相关。