Autoantibodies Against AT₁-receptor In Patients With Restenosis After Percutaneous Coronary Intervention

Background： The incidence of coronary artery disease(CHD) increases year by year,becoming the most important disease for death and disability. Percutaneous coronaryintervention(PCI) is one of the main methods for treatment. But PCI injured vascularendothelium, causing vascular smooth muscle cell proliferated, the matrix in blood vesselsformed and vascular remodeling, leading to restenosis(RS) atfer PCI. At present,the rate ofrestenosis after drug-eluting stent is still at5%-10%, and become an important factor to influencethe curative effect and prognosis in patients with coronary artery disease.(1) Autoantibodies against angiotensin II typel receptor (ATi-AA) is one of the G-proteincoupling receptor antibodies, having the similar role of angiotensin II. ATi-AA may causeendothelial dysfunction through the cross immune response and immune response mechanism toparticipate in development of cardiovascular diseases.(2) Endothelial cells are the major sites ofgeneration and exudation of endothelin-1(ET-1), which have the most lasting strongest to shirnkblood vessels. ET-1can promote inflammation, thrombosis, and vascular smooth muscle cellsproliferation and migraiton, the extracellular matrix form to mediated the formation anddevelopment of restenosis after PCI.(3) Adiponectin(APN) is a plasma hormonal protein deirvedand secreted rfom adipose cells, may protect the damaged vascular endothelium through multiplemechanisms such as stimulation insulin sensitization, antioxidant stress, anitatherosclerosis,anti-inflammation and reduce smooth muscle cells proliferation to intervent restenosis progress.Object: Through testing the existence of serum ATi-AA-, ET1and APN in patients withrestenosis, patients with no-restenosis and controls, to explore the role of ATi-AA in thedevelopment of paitents with restenosis after PCI.Method: Select93hospitalized paitents who include control(n=26) and paitents withcoronary heart disease accepted PCI previously who according to the results of coronaryangiography were divided into restenosis(n=35) and no restenosis(n=32). Blood samples of allsubjects were collected in the second day morning with empty stomach, centrifuged serum andstoraged in-80°Ccryopreservaiton. Detected the positive rate of ATi-AA and concentraitons ofET-1and adiponectin in the serum of all paitents by enzyme-linked immunosorbentassay (ELISA). There correlaiton is using by related analysis.Result:(l) Paitents with restenosis, the positive rates of autoantibodies against AT i-receptor were higher than without restenosis(45.7%vs21<.9%,?0.05)and controls(45.7%vs11.5%,P＜0.01); and there is no significant different in patients without restenosis and controls(21.9%vsH.5%,P＜0.05). The optical density value(OD) of positive ATVAA in paitents with restenosisand the degrees of restenosis after PCI were signiifcantly correlated positivity each other(r=0.884,P＜=0.OOKO.01).(2)The level of serum ET-1in paitents with restenosis was higher signiifcantlythan without restenosis(86.09士18.55pg/ml vs SA.STilS.TApg/ml’WO.Ol) and controls(86±.0918.55p^ml vs19.28±6.84pg/ml,力〈0.01); and there was a significantly increased in thepaitents without restenosi and the controls (54±.8712.74p^ml vs19.28士6.84pg/ml,?〈0.01). Thelevel of serum ET-1in patients with restenosis and the OD value of positive ATVAA weresigniifcantly correlated positivity each other (r=0^.792,/=0.OOKO.01).(3) The level of serumadiponecitn in paitents with restenosis was lower significantly than without restenosis(120.53士26.19ng/ml vs235.30士51〈.26ng/ml,?0.01) and controls(120.53±26.19ng/ml vs245.70±62.68ng/ml,?〈0.01); and there is no significant different in patients without restenosisand controls (235±.3051.26ng/ml vs245±.7062.68ng/ml,/M).05). The level of serumadiponecitn in paitents with restenosis and the OD value of positive ATVAA were signiifcantlycorrelated negaitvely each other(r=-0.664<, P=0.0130.05).Conclusion:(l)ATi-AA was expressed increasesingly in paitents with restenosis after PCI,and correlated with the degrees of restenosis, which showed ATi-AA might play a role in thepathophysiological process of restenosis after PCI.(2)There were a higher level of ET-1and alower level of adiponectin in paitents with restenosis atfer PCI, and both them were correlatedwith the OD value of positive ATi-AA, which showed ATi-AA might take part in thedevelopment of restenosis after PCI through the change of serum ET-1and adipomecitn.