Study On Relationship Between The Expressions Of LOX-1,CX3CR1 From Monocytes And In-stent Restenosis After PCI

Objective:Exploration of correlation between lectin like oxidized low-density lipoprotein receptor-1(LOX-1)and CX3C chemokine receptor 1(CX3CR1)from monocytes with in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)by comparison of the expression levels of LOX-1 and CX3CR1.Investigation of predictive effect of expression levels of LOX-1 and CX3CR1 from monocytes on ISR after PCI.Methods:A total of 160 patients undergoing coronary angiography(CAG)after PCI were enrolled from department of cardiology of TED A International Cardiovascular Hospital of Tianjin from October 2015 to April 2017.Among which,101 patients with coronary artery stenosis>50%were divided into ISR group,and 59 patients with coronary artery stenosis<50%were divided into non-ISR stenosis group(NISR group).A total of 182 volunteers from TED A International Cardiovascular Hospital of Tianjin were divided into control group.General clinical information and laboratory parameters of the 3 groups were recorded.Chapter 1:The surface protein Fluorescence intensities of LOX-1 and CX3CR1 from monocytes in peripheral blood of each group were determined by flow cytometry(ISR group:82 cases,NISR group:41 cases,control group:138 cases).The difference among the 3 groups was compared.Spearman correlation between fluorescence intensities of LOX-1,CX3CR1 from monocytes and baseline data was analyzed in ISR group.Logistic regression analysis,receiver operating characteristic(ROC)curve analysis and Cox regression analysis were performed on fluorescence intensities of LOX-1,CX3CR1 and ISR related factors.Chapter 2:The mRNA expressions of LOX-1 and CX3CR1 from monocytes in peripheral blood of each group were determined by real-time quantitative polymerase chain reaction(RT-qPCR)(ISR group:44 cases,NISR group:23 cases,control group:67 cases).The difference among the 3 groups was compared.Spearman correlation between mRNA expressions of LOX-1,CX3CR1 from monocytes and baseline data were analyzed in ISR group.Logistic regression and ROC curve analysis were performed on mRNA expressions of LOX-1,CX3CR1 and ISR related factors.Chapter 3:The total protein expressions of LOX-1 and CX3CR1 from monocytes in peripheral blood of each group were determined by Western blot assay(ISR group:41 cases,NISR group:20 cases,control group:72 cases).The difference among the 3 groups was compared.Spearman correlation between total protein expressions of LOX-1 and CX3CR1 from monocytes and baseline data was analyzed in ISR group.Logistic regression analysis and ROC curve analysis were performed on total protein expressions of LOX-1,CX3CR1 and ISR related factors.Results:Chapter 1:The surface protein fluorescence intensities of LOX-1 and CX3CR1 from monocytes were compared in three groups(ISR group,NISR group,control group),and the difference was of statistically significance(P<0.01).The fluorescence intensities of LOX-1,CX3CR1 in ISR group were higher than those in both NISR group(P<0.05)and control group(P<0.01).The fluorescence intensities of LOX-1 positively related to smoking history(r=0.229,P<0.05),TG(r=0.231,P<0.05),CK(r=0.267,P<0.05)and ASTm(r=0.380,P<0.01)in ISR group.The fluorescence intensities of CX3CR1 positively related to smoking history(r=0.240,P<0.05)in ISR group.Multiple logistic regression analysis and ROC curve analysis showed that fluorescence intensities of LOX-1 and Gensini score were hazards for ISR,and the combined usage of the two hazards had certain diagnostic value for ISR[sensitivity was 71.4%,specificity was 86.8%,area under curve(AUC)was 0.836].Besides,the fluorescence intensities of CX3CR1 and Gensini score were hazards for ISR,and the combined usage of the two hazards had certain diagnostic value for ISR(sensitivity was 81.3%,specificity was 74.4%,AUC was 0.853).Furthermore,Cox regression analysis indicated that either high expression of LOX-1 fluorescence intensities or CX3CR1 fluorescence intensities had a certain predictive value for ISR after PCI.Chapter 2:The mRNA expressions of LOX-1,CX3CR1 from monocytes were compared in three groups,and the difference was of statistically significance(P<0.01).The mRNA expressions of LOX-1 and CX3CR1 in ISR group were higher than those in NISR group(P<0.05)and control group(P<0.01).The mRNA expressions of LOX-1 positively related to PLT(r=0.337,P<0.05)and ASTm(r=0.385,P<0.05)in ISR group.Multiple logistic regression analysis and ROC curve analysis indicated that the mRNA expression of LOX-1 was an independent risk factor for ISR with certain diagnostic value(sensitivity was 77.4%,specificity was 75.0%,AUC 0.813).In addition,the mRNA expression of CX3CR1 was an independent risk factor for ISR with certain diagnostic value(sensitivity was 60.0%,specificity was 77.3%,AUC 0.787).Chapter 3:The total protein expressions of LOX-1(P<0.01)and CX3CR1(P<0.05)from monocytes were compared in three groups,and the difference was of statistically significance.The total protein expressions of LOX-1 in ISR group were higher than those in control group(P<0.01).The total protein expressions of CX3CR1 in ISR group were higher than those in control group(P<0.05).The total protein expressions of LOX-1 positively related to MPV(r=0.388,P<0.05)in ISR group.Multiple logistic regression analysis and ROC curve analysis indicated that total protein expression of LOX-1 was an independent risk factor for ISR with certain diagnostic value(sensitivity was 74.4%,specificity was 60.0%,AUC 0.732).Conclusions:The expressions of LOX-1 and CX3CR1 from monocytes increased in patients after PCI.LOX-1 and CX3CR1 may be involved in the process of ISR after PCI.The mRNA expressions,total protein expressions and surface protein fluorescence intensities of LOX-1 were risk factors for ISR after PCI with a certain diagnostic value.The surface protein fluorescence intensity of LOX-1 had a certain predictive value for ISR after PCI.The mRNA expressions and surface protein fluorescence intensities of CX3CR1 were risk factors for ISR after PCI with a certain diagnostic value.The surface protein fluorescence intensity of CX3CR1 had a certain predictive value for ISR after PCI.