Wu Kai-Li, Liang Qing-Hui, Huang Bin-Tao, Ding Na, Li Bo-Wei, Hao Jian
Renal Division, Department of Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Huhehot, 010050, Inner Mongolia, China.
Inner Mongolia Medical University, Huhehot, 010059, Inner Mongolia, China.
Arthritis Res Ther. 2020 Oct 2;22(1):228. doi: 10.1186/s13075-020-02321-w.
C-reactive protein (CRP) has two natural isomers: C-reactive protein pentamer (pCRP) and C-reactive protein monomer (mCRP). The levels of CRP are significantly elevated in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). mCRP not only activates the endothelial cells, platelets, leukocytes, and complements, but also has a proinflammatory structural subtype that can localize and deposit in inflammatory tissues. Thus, it regulates a variety of clinical diseases, such as ischemia/reperfusion (I/R) injury, Alzheimer's disease, age-related macular degeneration, and cardiovascular disease. We hypothesized that plasma mCRP levels are related to cardiovascular disease in AAV.
In this cross-sectional study, 37 patients with AAV were assessed. Brain natriuretic peptide (BNP) and mCRP in plasma were assessed by enzyme-linked immunosorbent assay (ELISA). The acute ST-segment elevation myocardial infarction (STEMI) was diagnosed by coronary angiography, and the Gensini score calculated. Echocardiography evaluated the ejection fraction (EF%), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular mass index (LVMI). Estimated glomerular filtration rate (eGFR) was calculated based on serum creatinine, age, and gender.
The plasma level of mCRP in AAV was significantly higher than that in healthy volunteers (P < 0.001). Then, mCRP and CRP levels were compared with and without STEMI complications in AAV. The plasma level of mCRP was higher, but that of CRP was lower in STEMI. The plasma level of mCRP was correlated with Birmingham vasculitis activity score (BVAS), eGFR, BNP, EF%, LVEDV, LVESV, LVMI, and STEMI complications' Gensini score in AAV; however, CRP did not correlate with BNP, EF%, LVEDV, LVESV, LVMI, and Gensini score.
The plasma level of mCRP was related to cardiovascular diseases in AAV patients.
C反应蛋白（CRP）有两种天然异构体：C反应蛋白五聚体（pCRP）和C反应蛋白单体（mCRP）。抗中性粒细胞胞浆抗体（ANCA）相关血管炎（AAV）患者的CRP水平显著升高。mCRP不仅能激活内皮细胞、血小板、白细胞和补体，还具有一种促炎结构亚型，可在炎症组织中定位和沉积。因此，它调节多种临床疾病，如缺血/再灌注（I/R）损伤、阿尔茨海默病、年龄相关性黄斑变性和心血管疾病。我们推测AAV患者血浆mCRP水平与心血管疾病有关。
在这项横断面研究中，对37例AAV患者进行了评估。采用酶联免疫吸附测定（ELISA）法检测血浆中的脑钠肽（BNP）和mCRP。通过冠状动脉造影诊断急性ST段抬高型心肌梗死（STEMI），并计算Gensini评分。超声心动图评估射血分数（EF%）、左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）和左心室质量指数（LVMI）。根据血清肌酐、年龄和性别计算估计肾小球滤过率（eGFR）。
AAV患者血浆mCRP水平显著高于健康志愿者（P＜0.001）。然后，比较了AAV患者有无STEMI并发症时的mCRP和CRP水平。STEMI患者血浆mCRP水平较高，但CRP水平较低。AAV患者血浆mCRP水平与伯明翰血管炎活动评分（BVAS）、eGFR、BNP、EF%、LVEDV、LVESV,、LVMI以及STEMI并发症的Gensini评分相关；然而，CRP与BNP、EF%、LVEDV、LVESV、LVMI和Gensini评分无关。
AAV患者血浆mCRP水平与心血管疾病有关。
