冠心病患者核因子-κB与血管细胞黏附分子-1的变化及其相关性

Changes in nuclear factor-κB and soluble vascular cell adhesion molecule-1 in acute coronary syndrome and their correlation

摘要:

目的：探讨冠心病患者外周血单核细胞核因子-κB（nuclear factor-κB，NF-κB）活性与血浆可溶性血管细胞黏附分子- 1（soluble vascular cell adhesion molecule，sVCAM-1）水平的变化及其相关性，在冠心病发生、发展和病情变化中的预测价值。方法：采用ELISA方法测定急性心肌梗死（acute myocardial infarction，AMI）、不稳定型心绞痛（unstable angina pectoris，UAP）、稳定型心绞痛（stable angina pectori，SAP）患者和对照组血浆sVCAM-1和NF-κB浓度，采用免疫组化染色检测上述患者的外周血单核细胞NF-κB P65的表达。结果：AMI组、UAP组外周血浆sVCAM-1、NF-κB的浓度及外周血单核细胞NF-κB的活性均高于健康对照组，差异均有统计学意义（P=0.000，P=0.000，P=0.000，P=0.002）。SAP组与健康对照组比较无明显差异（P=0.329，P=0.819）。AMI组、UAP组NF-κB、sVCAM-1表达均高于SAP组，AMI组NF-κB、sVCAM-1表达明显高于UAP组（P=0.000，P=0.000），且外周血单核细胞NF-κB与sVCAM-1的水平呈正相关（r=0.657，P=0.009）。结论：NF-κB、sVCAM-1均与动脉粥样硬化斑块稳定性密切相关，且二者均参与了冠心病的发生、发展。sVCAM-1可能通过促进NF-κB的活化而导致各种促动脉粥样硬化的细胞因子和趋化因子的生成，最终促使急性冠状动脉综合征（acute coronary syndrome，ACS）的发生。NF-κB作为引发炎症的关键转录因子可能上调sVCAM-1的表达。

Abstract:

Objective：To investigate changes in activity of nuclear factor-κB（NF-κB） in peripheral blood mononuclear cells and in plasma soluble vascular cell adhesion molecule-1（sVCAM-1） level，to discuss their correlation in patients with coronary heart dis－ease（CHD） and to explore their predictive value in occurrence，development and progress of CHD. Methods：Concentrations of plas－ma sVCAM-1 and NF-κB in patients with acute myocardial infarction（AMI），unstable angina pectoris（UAP） and stable angina pec－tori（SAP） as well as in health controls were determined by ELISA. NF-κB P65 expressiosns in peripheral blood mononuclear cells were determined by immunocytochemical staining and semiquantitative analysis. Results：Concentration of peripheral blood plasma sV－CAM-1 and NF-κB as well as NF-κB activity in peripheral blood mononuclear cells were higher in AMI and UAP group than in health control group，with statistical differences（P=0.000，P=0.000，P=0.000，P=0.002），however，there was no obvious difference in above indicators between SAP group and health control group（P=0.329，P=0.819）. NF-κB and sVCAM-1 expressions were higher in AMI and UAP group than in SAP group，higher in AMI group than in UAP group（P=0.000，P=0.000）. Activity of NF-κB in mononu－clear cells of peripheral blood was significantly correlated with plasma sVCAM-1 in ACS group（r=0.657，P=0.009）. Conclusions：NF-κB and sVCAM-1 are closely related with atherosclerotic plaque stability and both are involved in the occurrence of CHD develop－ment. sVCAM-1 might contribute to the production of cytokines and chemokines by activating NF-κB，which ultimately results in atherosclerosis and acute coronary syndrome. NF-κB as a key transcription factor in inflammation may increase expression of sV－CAM-1.