Atherosclerosis might, at least partly, be an inflammatory condition. Inflammation which is an immune response to injury characterized by swelling and redness which involves the production of proteins called “cytokines,” that attract cells of the immune system to the site of injury. In atherosclerosis, damage to the artery walls seems to trigger inflammation, which helps the atherosclerotic plaques grow. Because of the potential involvement of inflammation in atherosclerosis, increased levels of circulating cytokines might be associated with an increased risk of Coronary heart disease (CHD).Hence this study tries to investigate the expression of activation markers (Intra cellular adhesion molecules-1 and Heat shock protein 60) on peripheral blood lymphocytes (PBLs), and estimation of tumor necrosis factor-α (TNF- α), interleukin-6 (IL-6) and interleukin-10 (IL-10) serum levels in atherosclerotic patients (in acute and chronic cases). Correlate the results of PBLs-activation markers expression with the serological estimation of cytokines.
This study included fifty patients with coronary heart disease (40 males and 10 females), 11 patients (7 males and 4 females) with acute myocardial infarction were admitted to the Cardiac Care Unit (CCU) at Al-Kadhumyia Teaching Hospital in Baghdad, 39 patients (33 males and 6 females) were attendant as outpatient clinic of Ibn –Albetar Hospital in Baghdad with history of atherosclerotic chronic coronary insufficiency and fifteen, age and sex matched, apparently healthy individuals, taken as a healthy control group. Blood sample was taken from each subject and divided into 2 parts. The heparinized blood used for lymphocyte separation, the other part of blood was used for serum separation. Results showed that, the disease mostly affects males. Mean age of our patients was (59.12±8.54) year with a range from 42-80 years, in addition to these risk factors there are also other risk factors that accelerate the incidence of atherosclerosis and observed in our study: Twenty two (44%) of total patients were smokers, thirty three (66%) of total patients were hypertensive, twenty (40%) of total patients were diabetic, twenty (40%) of total patients with abnormal serum lipid profile, seven (14%) were obese, ten (20%) were had a family history of Ischemic heart disease. The sera of CHD patients group revealed that there was a high statistically significant difference in the concentrations of TNF-α, IL-6 and IL-10 between patients and control groups (P=0.000). The levels of TNF-α and IL-10 had significant difference (P< 0.05), between acute and chronic patients group (TNF-α ״pro inflammatory cytokine״more elevated in acute cases than in chronic cases, while IL-10 ״anti-inflammatory cytokine״more elevated in chronic cases than in acute cases) and there was no significant difference in the levels of IL-6 between acute and chronic patients group (P> 0.05).
Immunocytochemistry staining for ICAM-1 and HSP60, revealed a high statistically significant elevated levels between patients and control groups (P=0.000), there was a significant difference between acute and chronic cases patients group increase in expression of ICAM-1 on PBLs (P<0.05), and there was no significant difference between acute and chronic cases patients group in increase expression of HSP60 on PBLs (P>0.001). The possible correlations among used markers (ICAM-1״CD54״, HSP60) and serum level cytokines (TNF-α, IL-6, IL-10) were investigated in the current study and observed that there was positive correlation between ICAM-1 with TNF-α, there was no correlation between ICAM-1 with IL-6, and with IL-10. Positive correlation between HSP60 with TNF-α and with IL-6 where as no correlation was found between HSP60 with IL-10.Thus, we conclude that TNF-α, IL-10 and HSP60 are important markers act on coronary arteries which may contribute to the development of atheroma in CAD especially in the development of acute events, so in addition to their benefit as a biomarker in lab, they can be used as targets for drugs that interfere with their function at these stages.