A Study On The Relationship Between Acute Coronary Syndrome And Interleukins And Tumor Necrosis Factor

Object: In recent years, a lot of studies have showed that inflammation and immune mechanism take part in the pathophysiological process of atherosclerosis plague brokening which lead to the genesis and development of ACS. Many kinds of cytokines play important roles in the course. In this study, we measured and compared serum concentration of IL-6, IL-8, IL-10 and TNF-a in patients with different clinical kinds of coronary heart disease(CHD) to investigate the effect of inflammation and these cytokines on the genesis and development of CHD.Methods: 44 patients with acute myocardial infarction(AMI), 44 patients with unstable angina pectoris(UAP), 43 patients with stable angina pectoris(SAP) and 35 controls were studied. We measured their serum concentration of IL-6, IL-8, IL-10 and TNF-a and compared the results of different groups with each other.We also designed the value lg[(IL8+TNF)/IL10] and compare the result of each group.Results: (l)There was no significant difference in gender, age, hypertension, diabetes mellitus, smoking and serum concentration of lipid among the four groups patients(P>0.05). (2)Compared with SAP group and control group, the serum concentration of IL-6, IL-8, IL-10 and TNF-a in AMI group and UAP group were significantly increased (P<0.01). (3)Compared with UAP group, the serum concentration of IL-10 and TNF-a in AMI group was higher (P<0.05). But there was no significant difference in the serum concentration of IL-6 and IL-8 between the two groups (P>0.05). (4)There was also no significant difference in the serum concentration of these four cytokines between SAP group and control group (P>0.05). (5)The value lg[(IL8+TNF)/IL10] of AMI group was significantly lower than that of SAP group and control group.There was no significangtly difference between AMI group and UAP group,and there was also no significangtly difference among UAP, SAP and control groups.Conclusion: (1) CHD is closely associated with inflammatory reaction.Different kinds of cytokines participate in the progress of atherosclerosis. (2) IL-6 and IL-8 take part in the the pathophysiological process of atheromotous plaque's break which lead to the genesis and development of ACS. (3) As a kind of anti-inflammatory cytokine, IL-10 inhibites the activity of proinflammatory cytokines and adjusts the genesis and development of acute coronary events. (4) TNF-a may take part in the the pathophysiological process of ACS and may participates in the myocardial injury of acute myocardial infarction. (5) The increasing of inflammatory cytokines levels in serum can be valued as an index of the unstability of coronary atherosclerosis. (6) During the early phase of acute myocardial infarction, the degree that anti-inflammatory cytokines increased is probably raletively more prominent than that of promoting inflammatory cytokines.