lactoferrin and Angina--Stable

Psychosocial stress and activation of neutrophil granulocytes are increasingly recognized as major risk factors of coronary artery disease (CAD), but the possible relationship of these two factors in CAD patients is largely unexplored. Activation of neutrophils was reported to be associated with stenting; however, the issue of neutrophil state in connection with percutaneous coronary intervention (PCI) is incompletely understood from the aspect of stress and its hypothalamic-pituitary-adrenal axis (HPA) background. Thus, we aimed to study cortisol- and ACTH-associated changes in granulocyte activation in patients undergoing PCI.. Blood samples of 21 stable angina pectoris (SAP) and 20 acute coronary syndrome (ACS) patients were collected directly before (pre-PCI), after (post-PCI) and on the following day of PCI (1d-PCI). Granulocyte surface L-selectin, CD15 and (neutrophil-specific) lactoferrin were analysed by flow cytometry. Plasma cortisol, ACTH, and lactoferrin, IL-6 were also assayed. In both groups, pre- and post-PCI ratios of lactoferrin-bearing neutrophils were relatively high, these percentages decreased substantially next day; similarly, 1d-PCI plasma lactoferrin was about half of the post-PCI value (all p≤0.0001). Post-PCI ACTH was reduced markedly next day, especially in ACS group (SAP: p<0.01, ACS: p≤0.0001). In ACS, elevated pre-PCI cortisol decreased considerably a day after stenting (p<0.01); in pre-PCI samples, cortisol correlated with plasma lactoferrin (r∼0.5, p<0.05). In 1d-PCI samples of both groups, ACTH showed negative associations with the ratio of lactoferrin-bearing neutrophils (SAP: r = -0.601, p<0.005; ACS: r = -0.541, p<0.05) and with plasma lactoferrin (SAP: r = -0.435, p<0.05; ACS: r = -0.609, p<0.005).. Pre- and post-PCI states were associated with increased percentage of activated/degranulated neutrophils indicated by elevated lactoferrin parameters, the 1d-PCI declines of which were associated with plasma ACTH in both groups. The correlation of plasma cortisol with plasma lactoferrin in the extremely stressed ACS before stenting, however, suggests an association of cortisol with neutrophil activation.

Topics: Acute Coronary Syndrome; Adrenocorticotropic Hormone; Adult; Aged; Aged, 80 and over; Angina, Stable; Biomarkers; Coronary Artery Disease; Female; Humans; Hydrocortisone; Interleukin-6; L-Selectin; Lactoferrin; Lewis X Antigen; Male; Middle Aged; Neutrophils; Percutaneous Coronary Intervention; Stents

The primary aim of this study was to examine whether markers of cell damage and of the psycho-neuroendocrino-inflammatory/immune (PNI) system could be associated in patients with stable coronary artery disease (CAD) on the next day following percutaneous coronary intervention (PCI).. Blood samples of 23 patients (18 men and five women, mean age 62.9 ± 10.6 years), were collected immediately before (pre-PCI), immediately after (post-PCI), and on the day following PCI (1d-PCI). Lactoferrin, LL-37 and interleukin-6 (IL-6) were assayed in plasma, in addition to cortisol and chromogranin A (CgA), as well as CK, ASAT and ALAT. Total and differential leukocyte counts were also analysed.. At all the three time points, the monocyte fractions, the monocyte-to-lymphocyte and the neutrophil-to-lymphocyte ratios and CgA levels were elevated. We detected significant peri-procedural changes in the plasma levels of our PNI markers: IL-6 (p<0.05), lactoferrin, LL-37 (both: p <0.0001), CgA, (p<0.05), and cortisol (p<0.01). On the first day after PCI, highly significant associations were found of ASAT with IL-6 and neutrophil count (both: r>0.75, p<0.0001), and of CgA with neutrophil count and monocyte count (both: r>0.79, p<0.0001); furthermore, cortisol was also associated with neutrophil count (r>0.7, p<0.0001).. The findings suggest that myocardial damage could correlate not only with an inflammatory reaction but, via neutrophil count, also with increased level of stress in stable CAD after PCI. Furthermore, 1d-PCI neutrophil count may serve as an easy-to-obtain integrative PNI measure in stable CAD.

Topics: Adult; Aged; Alanine Transaminase; Angina, Stable; Antimicrobial Cationic Peptides; Aspartate Aminotransferases; Biomarkers; Cathelicidins; Chromogranin A; Creatine Kinase; Female; Humans; Hydrocortisone; Interleukin-6; Lactoferrin; Leukocyte Count; Male; Middle Aged; Neurosecretory Systems; Neutrophils; Percutaneous Coronary Intervention; Stents; Stress, Physiological

A significant increase in the myeloperoxidase (MPO) activity has been found in plasma of patients with stable angina and with acute coronary syndrome (ACS) in comparison with the control group. MPO concentration was significantly increased in plasma of ACS patients. Reduced MPO activity in the treated ACS patients correlated with a favorable outcome of the disease. Generally, changes in plasma MPO concentration coincided with changes in lactoferrin concentration thus confirming the role of neutrophil degranulation in the increase of plasma concentrations of these proteins. The increase in MPO activity was obviously determined by modification of the MPO protein caused by reactive oxygen species and halogen in the molar ratio of 1 : 25 and 1 : 50. The decrease in plasma MPO activity may be associated with increased plasma concentrations of the physiological inhibitor of its activity, ceruloplasmin, and also with modification of the MPO protein with reactive oxygen species and halogen at their molar ratio of 1 : 100 and higher. Thus, MPO activity may be used for evaluation of effectiveness of the treatment of cardiovascular diseases.. Vyiavleno dostovernoe uvelichenie aktivnosti mieloperoksidazy (MPO) v plazme krovi bol'nykh kak so stabil'noĭ stenokardieĭ, tak i s ostrym koronarnym sindromom (OKS) po sravneniiu s kontrol'noĭ gruppoĭ. Kontsentratsiia MPO dostoverno uvelichena v plazme krovi bol'nykh s OKS. Snizhenie aktivnosti MPO v protsesse lecheniia bol'nykh s OKS korreliruet s blagopriiatnym iskhodom zabolevaniia. Izmenenie kontsentratsii MPO v tselom sovpadaet s izmeneniem kontsentratsii laktoferrina, chto podtverzhdaet rol' degranuliatsii neĭtrofilov v povyshenii kontsentratsii dannykh belkov v plazme krovi. Uvelichenie aktivnosti MPO obuslovleno modifikatsieĭ belkovoĭ chasti molekuly aktivnymi formami kisloroda i galogenov v mol'nom sootnoshenii 1:25 i 1:50. Snizhenie aktivnosti MPO, s odnoĭ storony, sviazano s uvelicheniem v plazme krovi aktivnosti ee fiziologicheskogo ingibitora – tseruloplazmina, s drugoĭ storony, obuslovleno modifikatsieĭ fermenta aktivnymi formami kisloroda i galogenov v mol'nom sootnoshenii 1:100 i vyshe. Pokazana rol' monitoringa aktivnosti MPO dlia otsenki éffektivnosti terapii serdechno-sosudistykh zabolevaniĭ.

Topics: Acute Coronary Syndrome; Angina, Stable; Biomarkers; Case-Control Studies; Ceruloplasmin; Female; Humans; Lactoferrin; Male; Middle Aged; Peroxidase