Change Of Autophagy-related Protein Expression In Monocyte And Its Relationship With Angina Pectoris

Objective: To observe the changes of autophagy-related proteins such as ATG5,LC3 and P62 in peripheral blood monocytes of patients with angina pectoris,and explore the relationship between the generation and degradation of autophagosomes in monocytes and the clinical manifestations of coronary heart disease,and the correlation with the severity of coronary artery lesions.Methods: A total of 115 patients admitted to the Department of Cardiology in the Second Hospital of Dalian Medical University from June 2019 to December 2019 were collected.According to the inclusion criteria and exclusion criteria,34 Control patients,40 Stable Angina(SA)patients,and 41 Unstable Angina(UA)patients were selected.The medical history of the patients was collected by the cardiology physician,including:gender,age,weight,height,history of smoking and drinking,history of hypertension(normal blood pressure control,blood pressure during hospitalization),history of surgical trauma,history of chronic liver and kidney disease,rheumatism History of immune diseases,infectious diseases and family genetic diseases.Patients in the groups were collected fasting venous blood by the cardiology nurse on the day after admission to measure blood routine,myocardial markers,pro-BNP,renal function,liver biochemistry,blood lipid,plasma D-dimer,C-reactive protein,Homocysteine and other indicators.Two additional blood samples of EDTA anticoagulant tubes were taken,with a volume of 4ml.Monocytes were extracted by Ficoll density gradient separation.The expression of autophagy-related proteins such as ATG5,LC3 and P62 in monocytes of different groups of patients was detected by Western Blot.Patients enrolled in Control group underwent coronary angiography or coronary CTA.Patients enrolled in SA group and UA group underwent coronary angiography.Coronary angiography was performedby doctors with rich experience in cardiology department,and coronary CTA was performed by Imaging Department of Hospital.The Gensini score was performed according to the results of coronary angiography and it was used to assess the extend of coronary artery lesions.SPSS 21 software was applied to analyze the relevant data.Results: 1.The proportion of hypertension history and smoking history in UA group was higher than that in Control group,and the average age of patients in UA group was higher than that in SA group and Control group,the differences were statistically significant(P<0.05).2.HDL-C in UA group was lower than that in SA group and Control group;TC,LDL-C and Genini scores in UA group and SA group were higher than those in Control group,and Gensini scores in UA group were higher than those in SA group,the differences were statistically significant(P <0.05).3.There were no significant differences in systolic blood pressure,diastolic blood pressure,BMI,WBC,NEUT#,MONO%,PLT,Hb,ALT,AST,LDH,UA,Apo A1,Apo B,c Tn I,CK-MB,pro-BNP,Hcy,D-dimer(P> 0.05).4.The expression levels of ATG5 and LC3 in peripheral blood monocytes of patients in UA group and SA group were higher than those in Control group,and the expression levels in UA group were lower than those in SA group,the differences were statistically significant(P <0.05).5.The expression level of P62 in peripheral blood monocytes of patients in UA group was higher than that in SA group and Control group,the difference was statistically significant(P<0.05);but there was no statistically significant difference between SA group and Control group(P> 0.05).6.Based on the correlation analysis,it found that the expression levels of autophagy-related proteins in peripheral blood monocytes of patients in angina pectoris groups were correlated with the extend of coronary artery lesions(Gensini score): the expression level of ATG5 was negatively correlated with the Gensini score,rs =-0.694,P<0.001;the expression level of LC3 was negatively correlated with the Gensini score,rs =-0.672,P <0.001;the expression level of P62 was positively correlated with theGensini score rs = 0.715,P <0.001.Conclusion: 1.Autophagosome production increased in peripheral blood monocytes in patients with angina pectoris,while autophagosome production gradually decreased with the progress of angina pectoris,indicating that autophagosome production might be related to the occurrence and development of angina pectoris.2.Autophagosome clearance decreased in peripheral blood monocytes of patients with unstable angina pectoris,indicating that autophagosome clearance might be associated with the development and change of angina pectoris.3.There might be a correlation between the generation and clearance of autophagosome and the severity of coronary lesions in patients with angina pectoris.