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循环生物标志物趋化因子和血小板衍生生长因子BB与通过计算机断层扫描血管造影评估的颈动脉斑块易损性相关。

The Circulating Biomarker Fractalkine and Platelet-Derived Growth Factor BB are Correlated with Carotid Plaque Vulnerability Assessed by Computed Tomography Angiography.

作者信息

Yuan Xiaofan, Shen Guanru, Hu Qingzhe, Xiao Hongmei, Qin Xinyue

机构信息

Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China.

Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China.

出版信息

J Stroke Cerebrovasc Dis. 2022 May;31(5):106422. doi: 10.1016/j.jstrokecerebrovasdis.2022.106422. Epub 2022 Mar 4.

Abstract

OBJECTIVES

Although studies have demonstrated that inflammatory and lipid/ lipoproteins-related biomarkers, genetic mutations, and epigenetic mechanisms could be candidates for diagnosis and prognosis of ischemic stroke, there is still no consensus on how to identify vulnerable plaques based on circulating biomarkers.

MATERIALS AND METHODS

Histological and immunohistochemical staining were performed in the aorta sections of ApoE/ and WT mice. Eighty-nine patients who underwent CTA were included in this study. The degree of carotid stenosis and the wall features of plaque components were quantitatively analyzed. And the serum concentration of FKN and PDGF-BB were measured.

RESULTS

(1) The type V vulnerable atherosclerotic plaques deposited on the aortas of ApoE/ mice after feeding with western diet for 16 weeks. And the expression of CX3CR1 and PDGFR-β increased in the areas of atherosclerotic plaques, especially inside the fibrous cap of plaque. (2) Patients with symptomatic carotid stenosis showed larger LNRC, smaller calcified plaques and more plaque ulceration detected by CTA than asymptomatic stenosis patients. Plaque ulceration and size of LNRC were high risk factors for stroke while plaque calcification was less frequently associated with cerebrovascular ischemia. (3) The serum concentration of FKN was lower and of PDGF-BB was higher in the patients with carotid artery stenosis. Correlation analysis suggested that FKN and PDGF-BB correlated positively with carotid plaque calcification and LNRC respectively.

CONCLUSIONS

For prediction it is recommended to combine circulating biomarkers (FKN and PDGF-BB) and imaging biomarkersfor comprehensive diagnosis and risk stratification in carotid atherosclerotic stroke.

摘要

目的

尽管研究表明,炎症和脂质/脂蛋白相关生物标志物、基因突变及表观遗传机制可能是缺血性中风诊断和预后的候选指标,但对于如何基于循环生物标志物识别易损斑块仍未达成共识。

材料与方法

对载脂蛋白E基因敲除(ApoE−/−)小鼠和野生型(WT)小鼠的主动脉切片进行组织学和免疫组织化学染色。本研究纳入了89例行CT血管造影(CTA)的患者。对颈动脉狭窄程度和斑块成分的壁特征进行定量分析。并检测血清中FKN和血小板衍生生长因子BB(PDGF-BB)的浓度。

结果

(1)给予西方饮食喂养16周后,ApoE−/−小鼠主动脉上出现V型易损动脉粥样硬化斑块。CX3CR1和血小板衍生生长因子受体β(PDGFR-β)在动脉粥样硬化斑块区域,尤其是斑块纤维帽内部的表达增加。(2)有症状的颈动脉狭窄患者与无症状狭窄患者相比,CTA检测显示其脂质坏死核心(LNRC)更大、钙化斑块更小且斑块溃疡更多。斑块溃疡和LNRC大小是中风的高危因素,而斑块钙化与脑血管缺血的相关性较小。(3)颈动脉狭窄患者血清中FKN浓度较低,PDGF-BB浓度较高。相关性分析表明,FKN和PDGF-BB分别与颈动脉斑块钙化和LNRC呈正相关。

结论

为进行预测,建议结合循环生物标志物(FKN和PDGF-BB)和影像学生物标志物,用于颈动脉粥样硬化性中风的综合诊断和风险分层。

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