The Correlation Between Serum Levels Of HMGB1 And Syndrome Of Yin And Yang Differentiation Of Coronary Heart Disease

ObjectiveTo study the relationship between HMGB1、MCP-1、IL-18、 and MMP-9, with the stability of coronary artery atheromatous plaque、 the treatment based on syndrome of yin and yang differentiation of Traditional Chinese Medicine, to further discover the relationship between immune response, inflammatory reaction, coronary heart disease and the treatment based on syndrome of yin and yang differentiation of Traditional Chinese Medicine, a new basis. may be provided for the prevention, diagnose, risk stratification and the treatment of traditional Chinese medicine of coronary heart disease.MethodFifty-eight coronary heart disease patients who were cured between August, 2013and January,2014 in GuangDong Province Hospital Of Traditional Chinese Medicine were enrolled. The mean age was (65.3±7.05) years old,23 males and 25 females. There were 20 stable angina pectoris patients,20 unstable angina pectoris patients and 18 acute myocardial infarction patients among them. Thirty healthy individuals who were cured during the same time in our hospital without structural heart disease (but with good heart function) were enrolled as control group, the mean age was (65.23±8.21) years old,19 males and 12 females. To draw3 ml artery blood before the coronary angiography, put it into heparin anticoagulation tube (dissolved blood was abandoned), and take it to centrifuge for 15 minutes with the speeds 3000 circles/min in. Take supernatant into Ep tube, and put it into -80℃ refrigerator. To use ELISA kit to detect the High Mobility Group Box protein 1、Monocyte chemoattractant protein-1、 Matrix metallo proteinase-9、Interleukin-18 concentration of stored examples according to description.Result1、Serum HMGB1 level is gradually increased in controls,SA, UA and AMI groups indicating significant statistic difference (P<0.05); and is higher than the controls.2、Serum levels of MCP-1, IL-18 and MMP-9 are significantly higher in CHD groups than the control group, indicating significant statistic difference (p<0.05).3、There is significant correlation between HMGB1 and MCP-1IL-18 and MMP-9 level (n=58, r=0.461,0.449,0.463 (p<0.01)).4、The result of treatment based on syndrome of yin and yang differentiation of CHD:Serum levels of HMGB1 is significantly higher in the Yang deficiency syndrome CHD groups than the Yin deficiency syndrome group and deficiency of Yin and Yang syndrome group, indicating significant statistic difference (p < 0.05). There is significant statistic difference in the group of Yin deficiency syndrome group and deficiency of Yin and Yang syndrome group, (p< 05). Although there is no significant statistical differences between groups of MCP-1, MMP-9, IL-18, but its level of serum inflammatory cytokines descend as follows:Yin deficiency syndrome group) deficiency of Yin and Yang syndrome group) Yang deficiency syndrome group. Yang deficiency syndrome group is given priority to with multivessel lesions in the groups of the three. three syndrome groups are given priority to with multivessel lesions, average lesion count with Yin deficiency syndrome for the most;5、Serum levels of HMGB1 is significantly higher in the phlegm-turbid retention syndrome group than the syndrome of heart attacked by blood stasis and the syndrome group without phlegm-turbid retention and blood stasis, indicating significant statistic difference (p<0.05). There is significant statistic difference in the group of heart attacked by blood stasis and the phlegm-turbid retentio syndrome group with MCP-1. (p<05). Although there is no significant statistical differences between other groups of MCP-1,MMP-9, IL-18, but its level of serum inflammatory cytokines descend as follows: phlegm-turbid retention syndrome group) the syndrome of heart attacked by blood stasis) the syndrome group without phlegm-turbid retention and blood stasis.The syndrome of heart attacked by blood stasis is given priority to with multivessel lesions in the groups of the three. three syndrome groups are given priority to with multivessel lesions, average lesion count with the syndrome of heart attacked by blood stasis syndrome for the most.Conclusion1、Serum levels of HMGB1、MCP-1、IL-18、MMP-9 is gradually increased in SA, UA and AMI, indicating that HMGB1 has independently associated with different types of coronary artery disease. it can indirectly reflect the the active of the inflammatory in the plaque. Serum levels of HMGB1 level has positive correlation with MCP-1、IL-18 and MMP-9.So, these inflammatory cytokines may become one of the serum indicators to reflect the stability of the plaque. Take HMGB1 as the center of the inflammatory pathway,we can speculate its upstream and downstream, to predict the change of the inflammatory cytokines, speculated that it can become one of the inflammatory pathway of HMGB1 inflammatory cascade reaction pathways or not, anti-inflammatory therapy for the coronary heart disease (CHD) provides the reliable basis;2. There is significant correlation between serum levels of HMGB1 and the number of Vascular lesions that the Coronary angiography shows, speculated that serum levels of HMGB1 may associated with the formation of atherosclerosis and progress of pathological process;3. The result of treatment based on syndrome of yin and yang differentiation of CHD shows:serum levels of HMGB1、MCP-1、IL-18. MMP-9 with the treatment based on syndrome of yin and yang differentiation descend as follows:Yin deficiency syndrome group) deficiency of Yin and Yang syndrome group) Yang deficiency syndrome group, it speculates that Yin deficiency syndrome group always occur with ACS, however, throughout the evolution of the inflammatory response with the CHD patients, inflammatory is not the same as the heat toxin that the TCM says, it is a long time of insufficient of the qi of Yang, it is the imbalance of Yin and Yang of the whole body reaction.4. The result of treatment based on syndrome of yin and yang differentiation of CHD shows:serum levels of HMGB1、MCP-1、IL-18、MMP-9 descend as follows: phlegm-turbid retention syndrome group>the syndrome of heart attacked by blood stasis>the syndrome group without phlegm-turbid retention and blood stasis, which speculated that:in the process of inflammatory reaction related with CHD, serum levels of HMGB1 has a strong correlation with phlegm turbidity and blood stasis, and we can speculate that a stronger correlation with blood stasis from the vascular lesions.