Changes And Clinical Significance Of Serum HSP27 And IL-17 Levels In Patients With Acute Coronary Syndrome

Background and purpose:Acute coronary syndrome(ACS)is regarded as a common circulatory disease,including unstable angina(UA)and acute myocardial infarction(AMI)with or without ST segment elevation.Epidemiological data show that despite the systematic and standardized treatment,the incidence rate of ACS has been increasing in recent years.IL-17 is a pro-inflammatory cytokine,composed of 155 amino acids glycoprotein.Recent studies have discovered that IL-17,as a new inflammatory marker,is not only related to various inflammatory diseases,but also involved in the activation of endothelial cells,leading to endothelial dysfunction.Heat shock protein27(Hsp27)is a crucial member of the small molecule heat shock protein family.Studies have discovered that HSP27 is involved in various cellular processes including inflammation,apoptosis,maintenance of arterial wall homeostasis and cell migration,and protects cell function through a variety of mechanisms.In addition,HSP27 can also regulate the occurrence and development of atherosclerosis by protecting endothelial cells.Hcy is one of the essential amino acids in human body.Methionine is a sulfur-containing amino acid formed in the process of metabolism,which can damage vascular endothelium through a variety of ways.Previous studies have revealed that endothelial injury is considered to be the initial trigger factor of atherosclerosis,and it is also the key event for stable atherosclerotic lesions to transform into vulnerable plaques.In this paper,through the detection of peripheral serum HSP27 and IL-17 levels in ACS patients and normal group,we analyzed whether there were differences between the two groups in serum,and whether the serum HSP27 level in ACS patients was related to the level of inflammation in vivo,endothelial function and the degree of coronary artery disease,hoping to provide a theoretical basis for the prevention and treatment of ACS.method:A cross-sectional study was conducted on 112 patients hospitalized in cardiology department from July 1,2020 to October 31,2020.The data of age,gender,height,weight,blood pressure,past medical history,personal history,relevant laboratory test indexes and ultrasound examination were collected.Patients with severe organ failure,valvular heart disease,rheumatic heart disease,acute and chronic infectious diseases,autoimmune system diseases,blood system diseases,history of malignant tumor,history of cerebral infarction,and previous coronary stent implantation were excluded from the scope of this study.5ml of fasting venous blood was collected from all patients and injected into the vacuum blood collection tube with coagulant and inert separation gel.Centrifugation was performed at the speed of 3000 R / min for a quarter of an hour.The upper serum was transferred to the EP tube and stored in the refrigerator at-80 ℃.After all blood samples were gathered,serum HSP27 and IL-17 levels were detected by ELISA.SPSS 23.0 statistical software was used for data analysis.The counting data were expressed by constituent ratio(i.e.,%).Chi square test was used for comparison between groups.For the measurement data,the normal distribution was displayed with mean ± standard deviation,and the skew distribution was displayed with median(quartile interval).T test or analysis of variance was used to compare the data that met the normal distribution and homogeneity test of variance at the same instant,rank sum test(Mann Whitney U test)was used to compare the data that did not conform to the normal distribution and(or)homogeneity test.Spearman linear correlation analysis was used for correlation analysis.The area under the ROC curve(AUC)was used to count the specificity,sensitivity as well as best predictive value.P < 0.05 was regarded as statistically difference.Result:1.Compared with the control group,the serum levels of HSP27 and IL-17 in ACS group were significantly higher(P < 0.01),the serum Hcy level in ACS group was higher(P < 0.05).2.Compared with UA group,the serum levels of HSP27 and IL-17,Gensini score in AMI group were significantly higher(P < 0.01),the serum Hcy level in AMI group was higher(P < 0.05).3.There was a positive correlation between serum HSP27 and IL-17 levels in ACS group(r = 0.357,P < 0.01,y = 0.569 x + 93.738).There was a positive correlation between serum HSP27 and Gensini score in ACS group(r = 0.299,P <0.01,y = 0.092 x + 105.977).4.ROC analysis showed that the AUC of HSP27 was 0.985(95% CI:0.968-1.000;P < 0.01),and the optimal critical value was 96.98 ng/ml(sensitivity:90.8%,specificity: 100%).The AUC of IL-17 was 0.909(95% CI: 0.852-0.967;P <0.01),and the optimal cut-off value was 21.14 pg/ml(sensitivity: 87.4%,specificity:80.0%).Conclusion:1.The increase of serum HSP27 level in ACS patients may be related to the level of inflammation and endothelial function.2.HSP27 may be used as an index to judge the severity of ACS.3.Both HSP27 and IL-17 can predict ACS,and the sensitivity and specificity of HSP27 are superior to that of IL-17.