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Tsoporis JN, Triantafyllis AS, Kalogeropoulos AS, Izhar S, Rigopoulos AG, Rallidis LS, Sakadakis E, Toumpoulis IK, Salpeas V, Leong-Poi H, Parker TG, Rizos I. Differential Expression of Circulating Damage-Associated Molecular Patterns in Patients with Coronary Artery Ectasia. Biomolecules 2023; 14:10. [PMID: 38275751 PMCID: PMC10813324 DOI: 10.3390/biom14010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
Coronary artery ectasia (CAE) is defined as abnormal dilation of a coronary artery with a diameter exceeding that of adjacent normal arterial segment by >1.5 times. CAE is a pathological entity of the coronary arteries and characterized as a variant of coronary atherosclerosis. CAE frequently coexists with coronary artery disease (CAD). While inflammation appears to be involved, the pathophysiology of CAE remains unclear. Damage-associated molecular patterns (DAMPs), defined as endogenous molecules released from stressed or damaged tissue, are deemed as alarm signals by the innate immune system. Inflammatory agents can generate DAMPs and DAMPs can create a pro-inflammatory state. In a prospective cross-sectional study, we enrolled 29 patients with CAE and non-obstructive CAD, 19 patients with obstructive CAD without CAE, and 14 control subjects with normal (control) coronary arteries age- and sex-matched with the CAE patients, to investigate the differential expression of plasma DAMPs. Patients with CAE and non-obstructive CAD had increased plasma levels of the DAMPs S100B, S100A12, HMGB1, and HSP70, the DAMPs receptor TLR4, and miR328a-3p compared to CAD and controls. Plasma levels of the mir328a-3p target the protective soluble form of the DAMPs receptor for advanced glycation end products (sRAGE), and the antioxidant DJ-1 was decreased in both CAE and CAD compared to controls. In an in vitro human umbilical vein endothelial cells model, circulating levels of S100B, HMGB1, HSP70 as well as CAE patient plasma induced inflammatory responses. The differential expression of the DAMPs S100B, HSP70, HMGB1, and their receptors TLR4 and sRAGE in CAE versus CAD makes them attractive novel biomarkers as therapeutic targets and therapeutics.
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Affiliation(s)
- James N. Tsoporis
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, 30 Bond St., Toronto, ON M5B 1W8, Canada; (S.I.); (H.L.-P.); (T.G.P.)
| | - Andreas S. Triantafyllis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
- Askepeion General Hospital, 16673 Athens, Greece
| | - Andreas S. Kalogeropoulos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
- Hygeia HealthCare Group, Department of Cardiology, Mitera General Hospital, 15123 Athens, Greece
| | - Shehla Izhar
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, 30 Bond St., Toronto, ON M5B 1W8, Canada; (S.I.); (H.L.-P.); (T.G.P.)
| | - Angelos G. Rigopoulos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
| | - Loukianos S. Rallidis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
| | - Eleftherios Sakadakis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
| | - Ioannis K. Toumpoulis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
| | - Vasileios Salpeas
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
| | - Howard Leong-Poi
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, 30 Bond St., Toronto, ON M5B 1W8, Canada; (S.I.); (H.L.-P.); (T.G.P.)
| | - Thomas G. Parker
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, 30 Bond St., Toronto, ON M5B 1W8, Canada; (S.I.); (H.L.-P.); (T.G.P.)
| | - Ioannis Rizos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
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Liévano J, Ávila Y, Acosta G, Sánchez Cantillo JDJ. Infarto agudo de miocardio secundario a enfermedad coronaria ectásica y agenesia de la arteria coronaria derecha. REPERTORIO DE MEDICINA Y CIRUGÍA 2020. [DOI: 10.31260/repertmedcir.01217273.902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Se presenta el caso de un paciente de sexo masculino de 42 años de edad que cursa con episodio de infarto agudo del miocardio sin elevación del segmento ST, en quien se documenta enfermedad coronaria ectásica moderada a grave y como hallazgo incidental agenesia de la arteria coronaria derecha, entidad poco frecuente. Se realiza una revisión de los aspectos más relevantes de la literatura en ectasia coronaria y una breve descripción del hallazgo incidental.
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Abstract
The exact mechanisms underlying coronary artery ectasia (CAE) remain uncertain. This study aims to investigate whether and how inflammatory mediators play a role in the pathogenesis of CAE. The data sources of this study were located by literature searches on MEDLINE, Highwire Press and Google search engine for the year range 2000-2013. The most sensitive of the four types of plasma inflammatory mediators were cell adhesion molecules and systemic inflammatory markers followed by cytokines, while proteolytic substances were the least sensitive indicators of CAE. Hypersensitive C-reaction protein, homocysteine, intercellular adhesion molecule 1, vascular cell adhesion molecule 1, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-2, vascular endothelial growth factor and neopterin levels were significantly higher in CAE and coronary artery disease (CAD) patients than in controls without CAE. The percentage of granulocytes was higher in CAE, in comparison with individuals with normal coronary arteries. Polymerase chain reaction determination of angiotensin converting enzyme genotypes showed that the DD genotype was more prevalent in CAE patients than in CAD patients, while prevalence of the I allele was higher in CAD than in CAE patients. CAE is more a result of inflammatory processes than of extracellular matrix degradation, as demonstrated by investigations of plasma inflammatory mediators, activation markers and angiotensin converting enzyme genotypes. Contemporary theories are unable to explain CAE's predilection for the right coronary artery or the occurrence of multi-vessel and multi-segment involvement.
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Affiliation(s)
- Shi-Min Yuan
- Fujian Medical University, People's Republic of China
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Triantafyllidi H, Rizos I, Rallidis L, Tsikrikas S, Triantafyllis A, Ikonomidis I, Panou F, Rigopoulos A, Kremastinos DT. Aortic distensibility associates with increased ascending thoracic aorta diameter and left ventricular diastolic dysfunction in patients with coronary artery ectasia. Heart Vessels 2010; 25:187-94. [PMID: 20512445 DOI: 10.1007/s00380-009-1196-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Accepted: 08/14/2009] [Indexed: 12/18/2022]
Abstract
Coronary artery ectasia is usually linked to coronary atherosclerosis. Its primary defect is a destruction of vascular media, which leads to coronary dilatation. The aim of the present study is to evaluate whether ascending aorta present anatomical and functional wall changes in patients with coronary ectasia compared with patients without ectasia. Forty patients with known coronary ectasia (group A) underwent echocardiography in order to study aortic lumen diameter and wall properties (distensibility and stiffness index). Twenty-five patients with coronary artery disease (group B) and 40 individuals with normal coronary arteries (group C) served as control groups. Both ascending aorta diameter and ascending aorta index were significantly increased in group A compared with groups B and C (P < 0.05 and P < 0.001, respectively). Furthermore, in patients with ectatic coronary arteries ascending aorta index, systolic blood pressure and diastolic dysfunction independently associate with aortic distensibility. In patients with coronary artery ectasia, ascending aortic diameter could be enlarged while aortic stiffness is related to diastolic dysfunction. We suggest that coronary ectasia is not an isolated lesion but a reflection of a generalized vascular media defect, and should not be recognized as a benign entity.
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Affiliation(s)
- Helen Triantafyllidi
- Second Department of Cardiology, Medical School, University of Athens, Attikon Hospital, 83 Agiou Ioannou Theologou, Holargos, 155 61 Athens, Greece.
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The levels of tumor necrosis factor-alpha and interleukin-6 in patients with isolated coronary artery ectasia. Mediators Inflamm 2009; 2009:106145. [PMID: 19551157 PMCID: PMC2699491 DOI: 10.1155/2009/106145] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Accepted: 04/15/2009] [Indexed: 12/13/2022] Open
Abstract
Background/Aim. Coronary artery ectasia (CAE) is considered as a variant of atherosclerosis. Tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) are among the sensitive markers of systemic inflammation. The aim of this study was to
evaluate the plasma levels of the cytokines; TNF-α and IL-6 in CAE patients. Methods. Plasma concentrations of TNF-α and IL-6 were measured in 36 patients with CAE (28 males, mean age: 58.2 ± 12 years), and results were compared with age and
sex-matched controls (n = 32) without coronary artery ectasia. TNF-α and IL-6 concentrations in blood were assesed by
enzyme-linked immunosorbent assay (ELISA). Results.
Baseline characteristics of the two groups were similar.
TNF-α and IL-6 levels were significantly higher in CAE group
than controls (15.6 ± 11.2 pg/mL versus 7.8 ± 3.7 pg/mL, P < .001, and 17.2 ± 12.6 versus 7.6 ± 2.1 P < .0001, resp.). Conclusion. CAE patients showed
increases in TNF-α and IL-6 levels compared to the controls. This study
provides evidence for alterations in the proinflamatory cytokines
which suggest the involvement of the immune system in the
pathophysiology of CAE. Further placebo-controlled studies are
needed to evaluate the clinical significance of this increase in
TNF-α and IL-6 levels.
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