Human atheromatous plaques expressed sensing adaptor STING, a potential role in vascular inflammation pathogenesis

Atherogenesis is a complex physiological process involving inflammation and contributing to plaque development and vulnerability. The cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) pathway has emerged as a significant intracellular mechanism of innate immune defense programs. However, its involvement in atherogenesis has not been explored. In this brief report, we assessed the expression of STING protein in the artheriosclerotic (ATC) plaque of human patients. Our results showed that STING expression was detected in the ATC plaques. Most of the STING expression was noted in macrophages and lymphocytes. Of note, endothelial cells were constantly positive in all cases analyzed. STING expression was strong in the complicated ATC plaques near the cell debris and hemorrhagic foci. Considering these findings, we propose that cGAS-STING signaling plays a role in atherogenesis, opening novel avenues for therapeutic development.

The determination of copeptin levels helps management decisions among transient ischaemic attack patients

BACKGROUND

Most approaches to transient ischaemic attack (TIA) triage use clinical scores and vascular imaging; however, some biomarkers have been suggested to improve the prognosis of TIA patients.

METHODS

Serum levels of copeptin, adiponectin, neopterin, neuron-specific enolase, high-sensitivity C-reactive protein, IL-6, N-terminal pro-B-type natriuretic peptide, S100β, tumour necrosis factor-alpha and IL-1α as well as clinical characteristics were assessed on consecutive TIA patients during the first 24 h of the onset of symptoms.

RESULTS

Among 237 consecutive TIA patients, 12 patients (5%) had a stroke within 7 days and 15 (6%) within 90 days. Among all candidate biomarkers analysed, only copeptin was significantly increased in patients with stroke recurrence (SR) within 7 days (P = 0.026) but not within 90 days. A cut-off point of 13.8 pmol/l was established with a great predictive negative value (97.4%). Large artery atherosclerosis (LAA) [hazard ratio (HR) 12.7, 95% CI 3.2-50.1, P < 0.001] and copeptin levels ≥13.8 pmol/l (HR 3.9, 95% CI 1.01-14.4, P = 0.039) were independent predictors of SR at the 7-day follow-up. LAA was the only predictor of 90-day SR (HR 7.4, 95% CI 2.5-21.6, P < 0.001). ABCD3I was associated with 7- and 90-day SRs (P = 0.025 and P = 0.034, respectively). The association between copeptin levels and LAA had a diagnostic accuracy of 90.3%.

CONCLUSIONS

Serum copeptin could be an important prognostic biomarker to guide management decisions among TIA patients. Therefore, TIA patients with copeptin levels below 13.8 pmol/l and without LAA have an insignificant risk of 7-day SR and could be managed on an outpatient basis.