Rękas-Dudziak Anna Renata, Rojek Joanna, Blacha Anna, Pruszynska-Oszmałek Ewa, Kołodziejski Paweł, Matuła Przemysław
Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, Poland.
Department of Vascular Surgery, Hospital of the Ministry of the Internal Affairs and Administration, Poznan, Poland.
Anaesthesiol Intensive Ther. 2025 Jun 18;57(1):121-127. doi: 10.5114/ait/203169.
The pentraxins are a superfamily of proteins characterized by the presence of a pentraxin domain at the C-terminal. One of them is pentraxin 3 (PTX3), which is of great interest to scientists, primarily due to its function as an endogenous modulator of the inflammatory response. Local inflammation is a common phenomenon during various types of surgery and procedures, and its causes, among others, are local ischemia or tissue irritation. One such procedure is carotid plaque removal by carotid endarterectomy (CEA), which is performed to reduce the risk of stroke.
The purpose of this study was to investigate the effect of CEA on PTX3 concentration and the relationship between cognitive functions and the duration of brain ischemia in patients. We evaluated the relationships using blood collected from patients undergoing CEA, the Mini-Mental State Examination (MMSE) questionnaire, and commercially available ELISA tests.
Results: We found that the concentration of PTX3 increased after surgery (from 0.59 ± 0.11 to 1.29 ± 0.29 ng mL; < 0.01). Also, a decrease in the MMSE score was observed 24 hours after the procedure ( < 0.01). However, just one month after the procedure, it significantly increased compared to the day of admission to the hospital ( < 0.01). Our results did not demonstrate any interactions between the tested parameters. It can be concluded that neither the changes in PTX3 concentration following the procedure nor the timing of these changes directly contribute to the temporary deterioration of cognitive functions observed after CEA.
PTX3 increases independently of the duration of cerebral hypoxemia/ hypercapnia after clamping the carotid artery. This rise is an inflammatory marker that occurs independently within the central nervous system.
五聚体蛋白是一类蛋白质超家族,其特征是在C端存在一个五聚体蛋白结构域。其中之一是五聚体蛋白3(PTX3),它引起了科学家们的极大兴趣,主要是因为其作为炎症反应内源性调节剂的功能。局部炎症是各类手术和操作过程中的常见现象,其原因包括局部缺血或组织刺激等。颈动脉内膜切除术(CEA)就是这样一种操作,它用于降低中风风险。
本研究的目的是调查CEA对PTX3浓度的影响以及患者认知功能与脑缺血持续时间之间的关系。我们使用从接受CEA的患者采集的血液、简易精神状态检查表(MMSE)问卷以及市售酶联免疫吸附测定(ELISA)检测来评估这些关系。
我们发现术后PTX3浓度升高(从0.59±0.11增至1.29±0.29 ng/mL;P<0.01)。此外,术后24小时观察到MMSE评分降低(P<0.01)。然而,术后仅一个月,与入院当天相比,该评分显著升高(P<0.01)。我们的结果未显示所测参数之间存在任何相互作用。可以得出结论,术后PTX3浓度的变化及其变化时间均未直接导致CEA后观察到的认知功能暂时恶化。
PTX3浓度升高与颈动脉夹闭后脑缺氧/高碳酸血症的持续时间无关。这种升高是一种在中枢神经系统内独立发生的炎症标志物。