The Relationship Between Level Of Matrix Metalloproteinase-1 And Soluble CD40 Ligand In Patients With Unstable Angina

Background coronary atherosclerotic acute rupture usually results in unstable angina or acute myocardial infarction or sudden death ( acute coronary syndromes, ACS ), Entirety of fibrous cap is major decisive factor of stability of coronary atherosclerotic plaque ,matrix metalloproteinase (MMPs) plays key role in destroying the entirety of atherosclerotic plaque and promoting plaque rupture to lead to unstable coronary artery disease. Recently, the study discover that macrophages in atherosclerotic plaque are activated by CD40-CD40L interactions in T lymphocytes to secret a great deal of matrix metalloproteinase to degrade collagen , and to lead to plaque unstability . So, to examine matrix metalloproteinase level have important clinical significance in reflecting plaque unstability . But it is short of further exploration in the correlation between matrix metalloproteinase and CD40L or risk stratification and predicting the value of heart incidence in unstable angina.Objective (1) to examine the blood level of Cluster of Differentitation 40 Ligand (CD40L). Matrix Metalloproteinase-1 (MMP-1), Interleukin-1 beta (IL-1 3 ), C-reactive protein (CRP) in patients with unstable angina ,and to explore the correlation of MMP-land CD40L, MMP-1 and IL-1B , to explore the role matrix metalloproteinase regulated by CD40 ligand on pathophysiologicial mechanism in patient with unstable angina; (2) to examine the levels of C-reactive protein(CRP) in patients with unstable angina, and to analye the correlation of MMP-1 levels and incidences of heart events and CRP, to investigate the prognostic value and risk stratification of MMP-1 in unstable angina.Methods Concentration of serum soluble CD40 ligand ,MMP-1 and IL-1β were measured by Enzyme-linked Immunosorbent Assay in 36 patients with unstable angina, 24 patients with stable angina in 2003 January-June in Department of Cardiovascular Medicine,the First Affiliated Hospital of Zhengzhou University and 20 controls. 32 patients with unstable angina were divide into Braunwald's grade I > II , III,and also the levels of CRP were measured by immune-turbidimetry method , and to analyze the correlation of MMP-land CD40L, IL-1β , and also to analyze the correlation of MMP-1 and CRP in patients with unstable angina, and MMP-1 levels and occurrence of heart events were analyzed.Results (1) Serum level of MMP-1 (5.61+1.69ng/ml) were significantly higher in patients with unstable angina than those with stable angina (3.71 + 1.50ng/ml, P<0.01); and controls (2.31+0.88ng/ml, P<0.01); serum level of sCD40L (3.14+0.47ng/ml) were significantly higher in patients with unstable angina than those with stable angina (1.67+0.43ng/ml, P<0.01) and controls(1.07+0.36ng/ml, P<0.01) ; level of IL-1β (221.71 +44.71ng/L) were significantly higher in patients with unstable angina than those with stable angina(166.63+33.21ng/L, P<0.01) and controls (119.53+42.16ng/L, P<0.01). (2) MMP-1 level was positively correlated with CD40L in unstable angina r=0.486,(P<0.01), MMP-1 is stronger correlated with CD40L; MMP-1 is positively weaker correlated with IL-1β , r=0.369, (P<0.05) . (3) Level of MMP-1 were positively correlated with CRP in patients with unstable angina, r=0.489,(P<0.01) .(4) The incidences of heart events were significantly higher inpatients with elevated MMP-1 levels than in patients with lower levels of MMP-1.Conclusion (1) The blood levels of CD40L, MMP-1, IL-1β were higher in patients with unstable angina, The results suggest that it is possible reason of elevated MMP-1 level regulated by CD40L in the rupture of coronary artery plaque.(2) The levels of MMP-1 were positively correlated with CRP in patientswith unstable angina, suggest that level of MMP-1 is a highly sensitive and specific biochemical marker for assessing risk stratification and prognostic value.