The Correlation Research Of MMP-2,MMP-14 With Vulnerability Of Carotid Plaque And Ischemic Stroke

The paper involved two aspects:(1)The research between MMP-2,MMP-14 and related factors and the vulnerability of carotid plaque;(2)The correlative research between vulnerable carotid plaque and ischemic stroke.Part? The research between MMP-2,MMP-14 and related factors and the vulnerability of carotid plaqueObjective We investigated the correlation of MMP-2,MMP-14 and related factors with the vulnerability of carotid plaque.Our study was to explore the related factors which influence the stability of the plaques.Methods1.Carotid plaques were collected from patients undergoing CEA in the Department of Neurosurgery of the First affiliated hospital of Soochow University.55 patients(50 men,5 women)were recruited between January 2015 and June 2016.All of the plaques were divided into 23 stable carotid plaques and 32 vulnerable carotid plaques by imaging and histological analysis.2.Steady protein and m RNA levels of MMPs,vascular endothelial growth factor(VEGF),bone sialo protein(BSP)and osteopontin(OPN)were investigated by real-time polymerase chain reaction(Real-time PCR)and/or western blot between the stable and vulnerable groups.3.Immunohistochemistry was used to localize the expression level of MMP-2 and MMP-14 in stable and vulnerable plaques.Results1.We analyzed the m RNA level of various MMPs(MMP-1,-2,-3,-7,-9,-12,-13,2.-14,-15,-16,-17,-24,-25)between the stable and vulnerable plaque segments.The expression of MMP-2,-7,-9,-14 were higher in the vulnerable plaque compared to the stable plaque(*P<0.05),especially MMP-2,-9,-14(***P<0.001).3.Consistent with the m RNA expression,protein level of MMP-2(**P<0.01)and MMP-14(*P<0.05)were up-regulated in vulnerable plaques in comparison with those in stable plaques.The protein level of VEGF(*P < 0.05)and BSP(**P < 0.01)were also increased in vulnerable plaques.In contrast,the protein level of OPN was decreased in vulnerable plaques(**P<0.01).4.Density analysis revealed that the immunohistochemical staining of MMP-2 and MMP-14 were more intense among samples from vulnerable group than those from stable group.MMP-2 and MMP-14 staining was positive in ulcer plaque and the atheromatous lesions.Conclusion1.Elevated expression of MMP-2 and MMP-14 were associated with plaque vulnerability of human carotid plaques,which were importent factors predicting vulnerable plaque.2.Additionally,neovascuclarization factors including VEGF and bone factors including BSP and OPN were correlated with the destabilization of plaque.Neovascularization and calcification were important factors which influence the stability of plaques.Part? The Correlative Research Between the Vulnerable Carotid Plaque and Ischemic StrokeObjective To analysis the correlation between the vulnerability of carotid plaque and ischemic stroke and to explore the clinical significance of assessing vulnerable plaques accurately.Methods1.64 patients which undergo carotid endarterectomy(CEA)were classified into2.ischemic stroke group and non ischemic stroke group according to whether ischemic stroke symptoms occurred during the last 6 months before surgery.To judge the stable and vulnerable plaques,the patients were tested with carotid doppler ultrasonography(CDU)before surgery and the carotid plaques were observed with HE staining after CEA.We collected and analysed the clinical manifestation and risk factors of patients involved in the study.3.We analysised the relevance between the plaque characteristic and ischemic stroke with chi-square test.Kappa test were used to analysis the consistency of CDU and pathology.Results1.Patients in ischemic stroke group had statistically higher number of transient ischemic attack(TIA)and the stroke history compared to non ischemic stroke group(*P<0.05).2.Of the 44 in ischemic stroke group,CDU assessed vulnerable plaques 81.8%(36/44)and stable plaques 18.2%(8/44),pathology assessed vulnerable plaques 86.4%(38/44)and stable plaques 13.6%(6/44);Of the 20 in non ischemic stroke group,CDU assessed vulnerable plaques 35%(7/20)and stable plaques 65%(13/20),pathology assessed vulnerable plaques 40%(8/20)and stable plaques 60%(12/20).3.CDU and pathology assess vulnerable plaques in ischemic stroke group were obviously higher than that in non ischemia group(?2=13.67,P<0.001;?2=14.62,P<0.001).The results of CDU were well accordant to that of pathology results(Kappa=0.669,P<0.01).Conclusion1.The vulnerability of plaques were closely related to the ischemic stroke.2.CDU is a reliable examination method to assess vulnerable plaques.The accurate assessment of vulnerability of plaques has a great significance in preventing ischemic stroke.