RELATIONSHIP OF THE MAIN RISK FACTORS OF ATHEROSCLEROSIS WITH IMMUNE INFLAMMATION, CELLULAR AND HUMORAL IMMUNITIS IN CHD PATIENTS WITH STABLE StENOCARDIA
Summary. Introduction. Cardiovascular risk factors (RF) have various associations with inflammatory biomarkers. However, a significant number of markers of inflammation are not explained by traditional RF. The aim of the study was to identify a possible relationship between the main RF for atherosclerosis and the state of cellular and humoral parameters of acquired and innate immunity in order to understand the mechanisms of influence of RF on the development of atherosclerosis. Object and research methods. We examined 135 patients with stable coronary heart disease (CHD) with 1–2 RF (first group) and 92 patients with three or more RF (second group). The material for the immunological study was peripheral venous blood. To determine the parameters of cellular and humoral innate and adaptive immunity in blood serum and supernatants of mononuclear cells, enzyme immunoassay was used. Research results. In patients with CHD with three or more FR compared with 1–2 FR, the total lesion of the coronary arteries of the heart per year of life was 1.90 (1.16–2.68) against 1.37 (0.80–2.57) cu (p=0.08) (R=0.13; p=0.10), blood CRP level 5.0 (3.9–8.9) vs 3.2 (1.2–4.6) mg/l (p=0.004)(R=0.13; p=0.11), IL-6 in mononuclear cells — 2658 (2013–4432) against 2058 (1320–3500) pg/ml (p=0.022)(R=0.17; p=0.035), IL-8 in mononuclear cells — 2010 (1314–3320) against 1411 (920–2646) pg/ml (p=0.009) (R=0.21; p=0.010), diene conjugates in the blood — 3.0 (2.1–4.5) against 2.5 (1.6–3.8) cu (p=0.042) (R=0.15; p=0.054), peroxidation of apoВ proteins — 0.83 (0.60–1.25) against 0.72 (0.53–1.00) cu (p=0.014) (R=0.16; p=0.020), endothelium-dependent vasodilation in the cuff test — 4.2 (2.6–6.1) vs 7.5 (3.9–8.8)% (p=0.09) (R=–0,40;p= 0.089), sICAM — 640 (478–790) vs 473 (365–650) ng/ml (p=0.0009) (R=0.30); p=0.001). RF have a complex total effect on such components of cellular immunity as CD4 (R=0.36;F=7.4;p=0.01), sCD40L (R=0.42;F=2.4;p=0.028); for such components of humoral immunity as antibodies to the components of the arterial wall (R=0.43; F=4.1; p=0.005), circulating immune complexes (R=0.43; F=2.9; p=0.008), cholesterol-containing immune complexes (R=0.41; F=3.5; p=0.02), IgG (R=0.47; F=3.5; p=0.01); for pro-inflammatory factors such as IL-6 (R=0.35; F=4.3; p=0.007), IL-8 (R=0.48; F=3.3; p=0.004), sICAM R (0.73; F=7.8; p=0.0003) and CRP (R=0.52; F=3.5; p=0.003). Conclusions. Traditional RF have an unfavorable potentiating total effect on the pro-inflammatory cytokine status, cellular and humoral immunity, and the phagocyte system in patients with stable CHD with the greatest contribution to these changes in hypertension. The presence of three or more RF for atherosclerosis in patients with stable CHD is accompanied by a weak direct, but statistically significant relationship with the activity of the proinflammatory cytokines IL-6, IL-8 and CRP, lipid peroxidation and apoB proteins, with a tendency to a greater severity of coronary atherosclerosis compared with the presence of 1–2 RF. The presence of three or more RF for atherosclerosis in comparison with 1–2 RF does not worsen the functional state of the endothelium in patients with stable CHD.
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