Relation Of Plasma Tissue Kallikrein Binding Protein Levels To Severity Of Coronary Artery Disease And Possible Mechanism

Objective:To analyze the differences of the levels of human Tissue Kallikrein-binding Protein(Kallistatin,KS)in plasma of coronary heart disease(CAD)patients and evaluate the correlation between KS and the severity of coronary artery stenosis.Methods:A total of 151 patients with coronary angiography were enrolled in this study.Their clinical data and results of coronary angiography were collected.Plasma KS were measured by ELISA.Patients were stratified into four groups accoarding to the results of coronary angiography(single coronary artery stenosis,double coronary artery stenosis,triple coronaryartery stenosis and controls)and four groups according to Gensini score{0,(0,20],(20,40],(40,160]} at the second step.KS levels were compared between different groups and correlation analysis was made between KS and Gensini score.Results:(1)In the four groups which were stratified according to the results of coronary angiography,the levels of KS in control(95.35±32)?g/mL were significantly higher compared with single coronary artery stenosis(78.19±25.27)?g/mL,double coronary artery stenosis(66.19125.93)?g/mL,triple coronary artery stenosis(51.84±23.26)?g/mL.There were statistically significant differences among four groups(P<0.001).(3)In the four groups which were stratified according to Gensini score {0,(0,20],(20,40],(40,160]},the levels of KS were(101.66±36.50)?g/mL,(77.73±25.13)?gg/mL,(61.581±23.06)?g/mL,(53.80±123.92)?g/mL,There were statistically significant differences among four groups(P<0.001).(4)Also there was a significant negative correlation between plasma KS levels and the Gensini score(P<0.001,Correlation coefficient =-0.371).(5)In the experiment how KS affect the adhesion between mononuclear cells and VSMCs,numbers of mononuclear cells in each view of 4 groups(control,TNF-a,NF-a+0.1?M KS,TNF-a+0.5?M KS)are(65.5± 13.68)?(117.6136.88)?(93.3±23.10)?(67.2±14.09).(In every group,10 views are selected).Conclusions:It is first study showed that the plasma KS levels are remarkable lower in the groups of CAD compared with controls.It indicates a novel role of KS in the progress of coronary atherosclerosis and the development of CAD.