Helseth Ragnhild, Weiss Thomas W, Opstad Trine Baur, Siegbahn Agneta, Solheim Svein, Freynhofer Matthias K, Huber Kurt, Arnesen Harald, Seljeflot Seljeflot
Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Vienna,Austria.
Thromb Res. 2015 Dec;136(6):1240-4. doi: 10.1016/j.thromres.2015.10.005. Epub 2015 Oct 8.
Several genes are expressed in aspirated coronary thrombi in acute myocardial infarction (AMI), exhibiting dynamic changes along ischemic time. Whether soluble biomarkers reflect the local gene environment and ischemic time is unclear. We explored whether circulating biomarkers were associated with corresponding coronary thrombi genes and total ischemic time.
In 33 AMI patients undergoing percutaneous coronary intervention (PCI), blood samples were collected within 6-24h for markers related to plaque rupture (metalloproteinase 9, tissue inhibitor of metalloproteinases 1), platelet and endothelial cell activation (P-selectin, CD40 ligand, PAR-1), hemostasis (tissue factor, tissue plasminogen activator, plasminogen activator inhibitor 1, free and total tissue factor pathway inhibitor, D-dimer, prothrombin fragment 1+2), inflammation (interleukin 8 and 18, fractalkine, monocyte chemoattractant protein 1 (MCP-1), CXCL1, pentraxin 3, myeloperoxidase) and galectin 3, caspase 8 and epidermal growth factor (EGF). Laboratory analyses were performed by Proximity Extension Assay (Proseek Multiplex CVD I(96 × 96)), ELISAs and RT-PCR.
Only circulating P-selectin correlated to the corresponding P-selectin gene expression in thrombi (r=0.530, p=0.002). Plasma galectin 3, fractalkine, MCP-1 and caspase 8 correlated inversely to ischemic time (r=-0.38-0.50, all p <0.05), while plasma MCP-1, galectin 3 and EGF were higher at short (≤ 4 h) vs. long (>4h) ischemic time (all p <0.05).
The dynamic changes in circulating mediators along ischemic time were not reflected in the profile of locally expressed genes. These observations indicate a locally confined milieu within the site of atherothrombosis, which may be important for selective therapy.
急性心肌梗死(AMI)患者抽吸的冠状动脉血栓中有多个基因表达,且随缺血时间呈现动态变化。可溶性生物标志物是否能反映局部基因环境和缺血时间尚不清楚。我们探讨了循环生物标志物是否与相应的冠状动脉血栓基因及总缺血时间相关。
对33例行经皮冠状动脉介入治疗(PCI)的AMI患者,在6 - 24小时内采集血样,检测与斑块破裂相关的标志物(金属蛋白酶9、金属蛋白酶组织抑制剂1)、血小板和内皮细胞活化标志物(P - 选择素、CD40配体、蛋白酶激活受体 - 1)、止血标志物(组织因子、组织型纤溶酶原激活剂、纤溶酶原激活剂抑制剂1、游离和总组织因子途径抑制剂、D - 二聚体、凝血酶原片段1 + 2)、炎症标志物(白细胞介素8和18、趋化因子、单核细胞趋化蛋白1(MCP - 1)、CXCL1、五聚素3、髓过氧化物酶)以及半乳糖凝集素3、半胱天冬酶8和表皮生长因子(EGF)。通过邻近延伸分析(Proseek Multiplex CVD I(96 × 96))、酶联免疫吸附测定(ELISA)和逆转录 - 聚合酶链反应(RT - PCR)进行实验室分析。
仅循环中的P - 选择素与血栓中相应的P - 选择素基因表达相关(r = 0.530,p = 0.002)。血浆半乳糖凝集素3、趋化因子、MCP - 1和半胱天冬酶8与缺血时间呈负相关(r = - 0.38 - 0.50,均p < 0.05),而血浆MCP - 1、半乳糖凝集素3和EGF在缺血时间短(≤4小时)时高于缺血时间长(>4小时)时(均p < 0.05)。
循环介质随缺血时间的动态变化未在局部表达基因的谱中得到体现。这些观察结果表明动脉粥样硬化血栓形成部位存在局部受限的微环境,这可能对选择性治疗很重要。