| Background Coronary atherosclerotic heart disease(CAHD)is a common disease with very high morbidity and mortality all over the world.Though its direct cause is the atherosclerosis(AS)lesion in involved coronary artery,which then lead to insufficient blood supply for heart,however,the exact etiology and pathogenesis for AS has remained elusive.With the deepening of research,more and more evidence showed that,in addition to the abnormality of lipid metabolism participated in the pathogenesis of CAHD which was revealed previously,inflammation due to innate immunity actually plays an vary important role in the pathological mechanism of AS.Neutrophil extracellular traps(NETs),as one of the participants of innate immune inflammatory response,has been found to partake in the pathogenesis of CAHD by promoting the thrombosis in coronary artery AS.However,to our knowledge,the relationship between NETs level and the activation of alternative complement pathway(ACP),as well as the impact of their interaction on development of AS,has not been reported by now.This study will further explore the change of NETs level in peripheral blood of the patients with CAHD,and investigate the relationship between the NETs level and the activated ACP,as well as the possible role of this inflammatory pathway in the pathogenesis of AS.Objective To explore the relationship between the level of NETs in peripheral blood and the activation of ACP in patients with CAHD,and to investigate the role of this inflammatory pathway in the pathogenesis of AS.Methods 1.Case selection: 38 patients with active CAHD who had not received regular treatment recently were randomly selected as the Patient Group while 38 healthy volunteers matched with the case group in gender and age were selected as the Control Group.2.Detection of the research indicators in peripheral blood: Enzyme linked immunosorbent assay(ELISA)was employed to detect the levels of NETs,fragment a of activated B factor(Ba),fragment a of activated fifth complement(C5a)and myeloperoxidase(MPO)in peripheral blood of both the Patient Group and Control Group.3.Statistical analysis of the detected indicators: The levels of all the 4 detected indicators including NETs,Ba,C5 a and MPO in peripheral blood,were respectively compared between the Patient Group and the Control Group.Meanwhile,the correlations between the detected indicators in each group was statistically analyzed,respectively.The emphasis was focused on the relationship between the level of NETs and the activation of ACP in Patient Group,and on the possible impact mechanism of this inflammatory pathway on the pathogenesis of AS.Results 1.Indicator comparisons between the 2 groups: The levels of NETs,Ba,C5 a and MPO in the Patient Group were significantly higher than those in the Control Group [0.414 ± 0.128 vs 0.293 ± 0.170(OD value),P = 0.001;68.42 ± 29.54 vs 52.16 ± 18.51(pg/ml),P = 0.006;303.48 ± 139.45 vs 238.35±78.73(ng/ml),P= 0.014 and 70.91±34.20 vs 31.76±10.94(ng/ml),P<0.001,respectively].2.Relationship between indicators in each group: In Patient Group,there was a statistically significant positive correlation between the NETs and Ba(r = 0.5278,P= 0.0007).Also,the significant positive correlation was found between the C5 a and MPO(r = 0.3587,P = 0.0270).However,there was no significant correlation between the indicators in the Control Group.Conclusions 1.The significant higher level of NETs in CAHD patients might contribute to C5 a production by activating the ACP,which might then further promote neutrophil to degranulate and to exude more NETs,leading to the increase of MPO as a participant in the pathogenesis of AS by promoting oxidative stress and etc.2.The NETs increase in the patients with CAHD might perpetuate the chronic inflammation of innate immunity to sustain development of AS by such a vicious cycle: increased level of NETs-further activated ACP-elevated activation of neutrophils-increased level of NETs and more production MPO. |
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