The Study About The Relationship Between IL-8,IL-10,Ratio Of IL-8/IL-10and CHD, CAG, PCI

Background Coronary heart disease (CHD) has become a commom heart disease. The development of percutaneous coronary intervention (PCI) was developed so quickly in recent20years. A series of interventional technique appeared, such as percutaneous transluminal coronary angioplasty (PTCA) and coronary artery stent implantation. Now PCI is an important way to treat patients with CHD, so the mortality of CHD is lowered. PCI would injure the artery and trigger an inflammatory response. The inflammation plays an important role in the development of in-stent restenosis (ISR) and major adverse cardiac events (MACE), which leads to poor prognosis of patients.More and more research showed that the inflammation played an important role in the development of in-stent restenosis(ISR) and major adverse cardiac events(MACE) after PCI. Many cytokines take part in this pathogenesis, including IL-1,IL-4, IL-6,IL-8, IL-10,TNF-a and so on. Especially, interleukin-8(IL-8),interleukin-10(IL-10) and C reactive protein(CRP) have been paid attention to. IL-8is produced by many cells. It’s an inflammatory cytokine which acts as a role of chemotaxis. The function is dependent on the density of IL-8, and it’s also quick and enduring. IL-10is a very important anti-inflmmatory cytokine. It can inhibit the activity of mononuclear cell, macrophagocyte and so on. It is likely to play an important role in preventing the development of CHD. The CRP is an important marker of the inflammation. May be there exists inflammatory cytokine imbalance after PCI, which triggers a systemic inflammatory response. Nowadays, there are few reports about IL-8/IL-10imbalance after PCI.Objective:1.To investigate the levle of serum concentrations of IL-8,IL-10and hs-CRP before PCI. To analyse whether the different level of inflammation and anti-inflammation exists in each group.2. To investigate the levle of serum concentrations of IL-8,IL-10and hs-CRP after CAG or PCI. To analyse whether CAG or PCI triggeres acute inflammatory response.3. To investigate the changes of ratio of serum IL-8/IL-10after PCI.To analyse whether PCI strengthen the inflammatory reaction and the different inflammatory reaction in each group. The ratio of IL-8/IL-10post PCI was the dependent variable.the independent variable included the ratio of IL-8/IL-10before PCI,the Coronary Artery Gensini Score,the total lenght of stent,groups (value:SA1=1, SA2=2, UA=3). The method of multiple linear regression was used to analyze the relationship between the imbalance of cytokines and CHD,PCI.Study population and MethodsStudy population All patients who underwent stenting or CAG in our hospital from April2011to October2011were included in the study. Major exclusive criteria were valvular heart disease, Cardiomyopathy, malignant tumor, Acute or chronic infectious disease, Serious liver and kidney dysfunction, rheumatic disease. The total number of Study population was103.Methods A total of103patients undergoing coronary angiography (CAG) were recruited, who were divided into SA1group (patients with stable angina only undergoing CAG, n=31), SA2group (patients with stable angina undergoing PCI, n=34), and UA group (patients with unstable angina undergoing PCI, n=38). The patients with hypertension or diabetes were found in each group.The enzyme-linked immunosorbent assay(ELISA) was used to detect level of serum concentrations of IL-8and IL-10just before PCI and24h after the procedure. The level of serum hs-CRP was detected in the same way.Continuous variables were expressed as mean value±standard deviation (mean±SD),and the comparison between groups was analyzed with2independent-samplesttest; the comparison in the same group was analyzed with the paired t test. The date in3groups was analyzed with one-way ANOVA. The chi-square test was uesd to compared categorical variables. The ratio of IL-8/IL-10post PCI was the dependent variable. the independent variable included the ratio of IL-8/IL-10before PCI,the Coronary Artery Gensini Score,the total lenght of stent,groups (value:SA1=1, SA2=2, UA=3). The method of multiple linear regression was used to analyze the relationship between the dependent variable and the independent variable. The SPSS statistical package for Windows version13.0was used for the statistical analysis. A P value<0.05was considered statistically significant.Results:(1) The comparison of the markers before PCI.The level of IL-8in UA patients was higher than that in SA1patients (P<0.05). The level of hs-CRP in UA patients was higher than that in all SA1and SA2group (P <0.05).There was no difference in the level of IL-10among the the three groups.(2) There were no difference in the level of IL-10and IL-8between groups before and after CAG. The level of hs-CRP in groups after CAG was higher than that in groups before CAG (P<0.01). The level of IL-10and IL-8after PCI in group SA2were higher than that in the same group before (P<0.05, P<0.01).The same with the hs-CRP (P<0.01). There were no difference in the level of IL-10between before PCI and after PCI in group UA. The level of IL-8and hs-CRP after PCI in group UA were higher than that in group UA before PCI (P<0.01, P<0.01)(3) In both SA2and UA group, the ratio of IL-8/IL-10post PCI was higher than that before PCI (P<0.05, P<0.01). After PCI, the ratio of IL-8/IL-10in the UA group was higher than that in both SA1and SA2group (P<0.05, P<0.05).(4) The ratio of IL-8/IL-10before PCI and the situation of unstable angina correlated with the ratio of IL-8/IL-10after PCI. Conclusion:(1) There is different inflammatory response among patients with different kinds of CHD.(2) PCI triggeres acute inflammatory response.(3) There exists inflammatory cytokine imbalance after PCI, which triggeres a systemic inflammatory response. Moreover, this response is more obvious in patients with inflammatory cytokine imbalance before PCI and unstable angina..