Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Ziołowa 45-47, Katowice, Poland.
International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
Mediators Inflamm. 2018 Jul 9;2018:2691934. doi: 10.1155/2018/2691934. eCollection 2018.
Acute myocardial infarction (AMI) and coronary artery bypass graft (CABG) surgery are associated with a pathogen-free inflammatory response (sterile inflammation). Complement cascade (CC) and bioactive sphingolipids (BS) are postulated to be involved in this process.
The aim of this study was to evaluate plasma levels of CC cleavage fragments (C3a, C5a, and C5b9), sphingosine (SP), sphingosine-1-phosphate (S1P), and free hemoglobin (fHb) in AMI patients treated with primary percutaneous coronary intervention (pPCI) and stable coronary artery disease (SCAD) undergoing CABG.
The study enrolled 37 subjects (27 male) including 22 AMI patients, 7 CABG patients, and 8 healthy individuals as the control group (CTRL). In the AMI group, blood samples were collected at 5 time points (admission to hospital, 6, 12, 24, and 48 hours post pPCI) and 4 time points in the CABG group (6, 12, 24, and 48 hours post operation). SP and S1P concentrations were measured by high-performance liquid chromatography (HPLC). Analysis of C3a, C5a, and C5b9 levels was carried out using high-sensitivity ELISA and free hemoglobin by spectrophotometry.
The plasma levels of CC cleavage fragments (C3a and C5b9) were significantly higher, while those of SP and S1P were lower in patients undergoing CABG surgery in comparison to the AMI group. In both groups, levels of CC factors showed no significant changes within 48 hours of follow-up. Conversely, SP and S1P levels gradually decreased throughout 48 hours in the AMI group but remained stable after CABG. Moreover, the fHb concentration was significantly higher after 24 and 48 hours post pPCI compared to the corresponding postoperative time points. Additionally, the fHb concentrations increased between 12 and 48 hours after PCI in patients with AMI.
Inflammatory response after AMI and CABG differed regarding the release of sphingolipids, free hemoglobin, and complement cascade cleavage fragments.
急性心肌梗死（AMI）和冠状动脉旁路移植术（CABG）与无病原体的炎症反应（无菌性炎症）有关。补体级联（CC）和生物活性神经鞘脂（BS）被认为参与了这一过程。
本研究旨在评估接受经皮冠状动脉介入治疗（pPCI）的 AMI 患者和接受冠状动脉旁路移植术（CABG）的稳定型冠状动脉疾病（SCAD）患者的血浆补体级联裂解片段（C3a、C5a 和 C5b9）、神经鞘氨醇（SP）、鞘氨醇-1-磷酸（S1P）和游离血红蛋白（fHb）水平。
本研究纳入了 37 名受试者（27 名男性），包括 22 名 AMI 患者、7 名 CABG 患者和 8 名健康个体作为对照组（CTRL）。AMI 组患者分别于入院时、pPCI 后 6、12、24 和 48 小时采集血样，CABG 组患者分别于术后 6、12、24 和 48 小时采集血样。采用高效液相色谱法（HPLC）测定 SP 和 S1P 浓度。采用高灵敏度 ELISA 法测定 C3a、C5a 和 C5b9 水平，分光光度法测定游离血红蛋白。
与 AMI 组相比，接受 CABG 手术的患者的 CC 裂解片段（C3a 和 C5b9）水平显著升高，而 SP 和 S1P 水平则较低。在两组患者中，CC 因子水平在 48 小时内均无明显变化。相反，AMI 组 SP 和 S1P 水平在 48 小时内逐渐下降，但 CABG 术后保持稳定。此外，与 CABG 术后相应时间点相比，pPCI 后 24 和 48 小时的 fHb 浓度显著升高。此外，AMI 患者在 PCI 后 12 至 48 小时之间 fHb 浓度增加。
AMI 和 CABG 后的炎症反应在神经鞘脂、游离血红蛋白和补体级联裂解片段的释放方面存在差异。
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