The Clinical Significance Of IL-18 And SCD40L Serum Levels In Coronary Heart Disease

BackgroudCoronary heart disease is one of the most critical deseases that threatens human being all over the world.But till now ,its pathogenesis is still unknown completely.Many risk factors such as hyptetension,diabetes hyperlipidemia,smoking and obesity can only explain part of it.Recently,more and more experimental evidences and epidemiological statistics strongly support that inflammatory reaction is obviously correlated with the occurrence of coronary heart disease.Therefor,improved understanding of these inflammatory processes may provide a new clue to assist in preventing and curing coronary heart disease.IL-18 is a pro-inflammatory factor which is correlated with the innate and adaptive immune mechanisms.It plays an important role in atherosclerosis.It influences the stability of plaques.sCD40L stems essentially from platelets which can arose the inflammation reaction of the endothelial cell.The interaction between sCD40L and CD40 can incread the secretion of cytokines,chemokines,matrix metalloproteinases and tissue factor that trigger the progress of coronary atherosclerosis.ObjectiveCHD is a kind of syndromes that is resulting from the interaction between genetic and circumstance.Inflammation plays a key role in the mechanism of CHD.This acticle selecting the patients whose angiography were negative as the control group,aims to explore th variability of IL-18 and sCD40L serum levels in different groups of CHD,to study the relationship between the characteristic of plaques and IL-18 and sCD40L serum levels and to investigate the influence of PCI on the serum levels of IL-18 and sCD40L and whether IL-18 and sCD40L can be the predictive factors of CHD.Through this study,we are hoping to provide a new clue for intervention of CHD on the early stage and prevention of coronary artery from restenosis after PCI.Methods180 patients whose mean age was 62±11.2 years were investigated in this study.Among them,there were 118 men and 62 women.The angiography was performed on all the patients.21 patients with negative ruslts of angiography were selected as control group(NS). We measure the serum levels of IL-18 and sCD40L through ELISA.Statistic analyses were performed with the SPSS 12.0. Value were considered statistically significant at P<0.05.Rusults1.The IL-18 and sCD40L serum levels in each group were, NS(20.9±10.5mg/L,1.82±1.01ng/mL), SA (25.6±12.3mg/L,2.70±1.09 ng/ml), UA (66.8±11.2 mg/L,3.75±1.04ng/ml) and AMI (98.4±10.6 mg/L,6.86±1.09 ng/ml)respectively.When compared each other ,there were significant difference (P<0.05).2.The IL-18 and sCD40L serum levels in each group befor PCI were, SA (23.6±11.3mg/L , 2.62±1.04 ng/ml), UA (58.8±10.5 mg/L,3.55±1.05ng/ml).After PCI,the IL-18 and sCD40L serum levels in each group were SA (39.2±11.0mg/L,5.25±1.02 ng/ml), UA (91.1±12.0 mg/L,5.68±1.04ng/ml). The differences were significant (P<0.05).3.With IVUS-VH, the patients were diveded into four groups(A,B,C and D) according to the lipid plaques ratio . The lipid plaques ratio of group A was 0-25%, B was 26%-50%,C was 51%-75%, D was 76%-100%.The IL-18 and sCD40L serum levels of group A were (34.5±11.5pg/ml,1.32±1.06ng/ml),B were(51.6±12.6pg/ml,2.26±1.05ng/ml),C were(76.4±10.2pg/ml,3.25±1.05ng/ml)and D were(105.4±13.2 pg/ml, 4.12±1.04ng/ml). With the increasing of the lipid plaques ratio , the IL-18 and sCD40L serum levels were increased (P<0.05). Conclusion1.With the increasing hazard risk of CHD,the IL-18 and sCD40L serum levels were increased.It indicated that the IL-18 and sCD40L levels may reflect the risk of CHD.2.After PCI,the IL-18 and sCD40L serum levels in SA group and UA group were increased significantly. It indicated that PCI may damage the intimate membrance and triger the inflammation.3.The IL-18 and sCD40L levels may reflect the risk of coronary artery disease and may be as the index of the vulnerability of the coronary plaques.