Liang Shao, Aiqun Ma, Jiwu Li, Ping Zhang
Department of Cardiology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Immunol Res. 2016 Apr;64(2):424-30. doi: 10.1007/s12026-015-8685-6.
In-stent restenosis is still a clinic trouble for percutaneous coronary intervention in drug-stent era. The molecular basis of restenosis is intensively associated with inflammation. TLR3 and TLR4 as innate immune factors have been proven to play a key role in atherosclerosis disease. The aim of this study is to study the TLR3 and TLR4 expressions and their downstream signaling proteins in the inflammatory process of restenosis after drug-stent therapy. mRNA and protein expression of TLR3 and TLR4 were detected in peripheral blood monocytes of primary group (n = 38), N-ISR group (n = 36) and ISR group (n = 33). Some inflammatory factors (including TLR3 and TLR4) were evaluated in serum of three groups. mRNA and protein expression of TLR3 and TLR4 and their downstream signaling proteins have shown a higher level in restenosis patients than non-restenosis patients and even primary patients who accepted first stent therapy. In serum, different from some nonspecific and downstream inflammatory factors, TLR3 and TLR4 also show a significantly higher level in ISR group compared with N-ISR group and primary group. This study provides a potential clinical biomarker for in-stent restenosis in drug-stent patients and some interesting data about the role of TLRs and their downstream signaling factors in the inflammatory process of in-stent restenosis. Compared with first stent therapy and non-restenosis patients, it is hopeful that TLR3 and TLR4 are potential noninvasive biomarkers in prognosis restenosis.
在药物洗脱支架时代，支架内再狭窄仍是经皮冠状动脉介入治疗的一个临床难题。再狭窄的分子基础与炎症密切相关。Toll样受体3（TLR3）和Toll样受体4（TLR4）作为天然免疫因子，已被证实在动脉粥样硬化疾病中起关键作用。本研究旨在探讨药物洗脱支架治疗后再狭窄炎症过程中TLR3和TLR4的表达及其下游信号蛋白。检测了原发组（n = 38）、非支架内再狭窄组（N-ISR组，n = 36）和支架内再狭窄组（ISR组，n = 33）外周血单核细胞中TLR3和TLR4的mRNA和蛋白表达。评估了三组血清中的一些炎症因子（包括TLR3和TLR4）。与非再狭窄患者甚至接受首次支架治疗的原发患者相比，再狭窄患者中TLR3和TLR4的mRNA和蛋白表达及其下游信号蛋白水平更高。在血清中，与一些非特异性和下游炎症因子不同，与N-ISR组和原发组相比，ISR组中TLR3和TLR4水平也显著更高。本研究为药物洗脱支架患者的支架内再狭窄提供了一个潜在的临床生物标志物，以及一些关于Toll样受体及其下游信号因子在支架内再狭窄炎症过程中作用的有趣数据。与首次支架治疗患者和非再狭窄患者相比，TLR3和TLR4有望成为预测再狭窄的潜在无创生物标志物。
