muramidase and Angina-Pectoris

To identify a plasma biomarker of atheromatous disease.. Surface-enhanced laser desorption ionization-time-of-flight mass spectrometry was used to identify possible plasma protein biomarkers of atheromatous disease in patients presenting with chronic stable angina pectoris by comparing those with 3-vessel disease with those without any evidence of coronary artery disease. The level of a 14.7-kDa protein was elevated; this protein was isolated and identified as a lysozyme. Arterial plasma lysozyme levels, measured by immunoassay, confirmed this observation in separate cohorts of patients. The application of arterial plasma lysozyme levels to 197 patients with varying degrees of coronary artery disease, using a cutoff value of 1.5 microg/mL, was able to distinguish patients with 1 or more occluded coronary arteries, with 86% sensitivity and 93% specificity. Of 20 patients with carotid atheroma, 19 had increased arterial plasma levels. In contrast, C-reactive protein levels showed no association with disease severity. Venous lysozyme levels in patients with carotid atheroma were shown to decrease after intensive atorvastatin treatment.. Raised plasma lysozyme levels may be a useful biomarker of atherosclerotic cardiovascular disease and response to therapy. Additional studies to investigate this are warranted.

Topics: Aged; Angina Pectoris; Atorvastatin; Biomarkers; C-Reactive Protein; Carotid Artery Diseases; Coronary Angiography; Coronary Artery Disease; Female; Heptanoic Acids; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Immunoassay; Male; Middle Aged; Muramidase; Predictive Value of Tests; Pyrroles; Sensitivity and Specificity; Severity of Illness Index; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Treatment Outcome; Up-Regulation

Changes of systemic immune status, involved in the immunopathogenesis of atherosclerosis, have been identified in patients with unstable angina pectoris. The developing acute myocardial infarction is accompanied by the formation of a myocardial aseptic inflammatory focus, from which biologically active products are absorbed, resulting in additional immunologic shifts. A differential diagnosis algorithm has been evolved on the basis of the comparison of a series of biochemical and immunologic parameters in patients with unstable angina, investigated at the peak of its clinical manifestations, and those with acute myocardial infarction.

Topics: Adult; Aged; Angina Pectoris; Angina, Unstable; Antigen-Antibody Complex; Diagnosis, Differential; Humans; Leukocyte Count; Lipids; Male; Middle Aged; Muramidase; Myocardial Infarction; Phagocytosis

A comparative study of biochemical and immunologic patterns showed lipostabil treatment to be effective in less than half of the patients with unstable angina. A method is developed for in vitro testing of individual blood mononuclear sensitivity to lipostabil effects. The proposed set of biochemical and immune assays allows the selection of patients subject to lipostabil treatment and provides additional criteria for the assessment of its efficiency.

Topics: Adult; Angina Pectoris; Angina, Unstable; Cholesterol; Humans; In Vitro Techniques; Leukocyte Count; Leukocytes; Lipoproteins; Male; Middle Aged; Muramidase; Phosphatidylcholines