Prediction of serum interleukin-6 level on the myocardial injury in patients with acute myocardial infarction

doi:10.3877.cma.j.issn.2095-5820.2014.02.009

Abstract

Abstract:

Objective

To investigate the prediction of serum interleukin-6 (IL-6) level in patients with acute myocardial infarction (AMI) on the myocardial injury.

Methods

A case control study enrolled 54 patients with AMI in the Department of Emergency and the Department of Cardiology, Xinhua Hospital, and 20 healthy donors from the Medical Examination Center of the same Hospital from November 2012 to May 2013. AMI patients were divided into two groups according to the levels of serum IL-6 within 24 h after attack. The levels of IL-6 and transforming growth factor β1 (TGF-β1) were measured by ELISA. The serum levels of the other 19 cytokines were measured using Luminex assay. CD₄⁺CD₂₅⁺Foxp3⁺Treg and Th17 cells were analyzed by flow cytometry. Both clinical and biochemical indicators were measured and analyzed in the Department of Laboratory.

Results

BCompared with the healthy donors, the levels of high sensitivity C reactive protein (hs-CRP) and creatine kinase-MB(CK-MB) were significantly higher in the two AMI groups (all P ＜0.05); and the levels in IL-6⁺ group were significantly higher than those in IL-6 group (hs-CRP: 8.43 (1.28-10.75) μg/L vs 0.55 (0.15-1.35) μg/L, Z=27.3,P＜0.05; CK-MB: 25.0 (14.0-66.0) μg/L vs 11.5 (8.8-17.0) μg/L, U=217, P＜0.05). The levels of IL-17, TGF-β, tumor necrosis factor α (TNF-α), and Th17 cells in IL-6⁺ and IL-6^- AMI were both significantly higher than the normal donors, while there was no difference between two AMI groups. CD₄⁺CD₂₅⁺Foxp3⁺Treg cells in IL-6⁺ and IL-6^- AMI patients were both lower than those in normal donors, while there was also no difference between the two AMI groups.

Conclusions

IL-6⁺AMI patients presented more severe myocardial damage (TNI as indicator) and inflammation(hs-CRP, IL-10 and IL-8 as indicator). IL-6 could be used for the risk stratification in AMI.

Key words: Acute myocardial infarction, Interleukin 6, Cytokine

Yanhui Ma, Lin Deng, Xiangliang Yuan, Ling Xu, Li Li, Lisong Shen, Weiping Xu. Prediction of serum interleukin-6 level on the myocardial injury in patients with acute myocardial infarction[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2014, 02(02): 106-111.

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References 32

1	Maseri A. Inflammation, atherosclerosis, and ischemic events - exploring the hidden side of the moon [J]. N Engl J Med, 1997,336(14):1014-1016.
2	Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis [J].Circulation, 2002,105(18):1135-1143.
3	Libby P, Ridker PM, Hansson GK. Progress and challenges in translating the biology of atherosclerosis [J]. Nature, 2011,473(7347): 317-325.
4	Yellon DM, Hausenloy DJ. Myocardial reperfusion injury [J]. N Engl J Med, 2007,357(23):1121-1135.
5	Ridker PM, Rifai N, Stampfer MJ, et al. Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men [J]. Circulation, 2000,101 (15):1767-1772.
6	Tedgui A, Mallat Z. Cytokines in atherosclerosis: pathogenic and regulatory pathways [J]. Physiol Rev, 2006,86(2):515-581.
7	Hansson GK. Inflammation, atherosclerosis, and coronary artery disease [J]. N Engl J Med, 2005,352(16):1685-1695.
8	Empana JP, Jouven X, Canouï-Poitrine F, et al. C-reactive protein,interleukin 6, fibrinogen and risk of sudden death in European middleaged men: the PRIME study [J]. Arterioscler Thromb Vasc Biol,2010,30(10):2047-2052.
9	Ridker PM, Rifai N, Stampfer MJ, et al. Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men [J]. Circulation, 2000,101(105):1767-1772.
10	Ammirati E, Cannistraci CV, Cristell NA, et al. Identification and predictive value of interleukin-6⁺ interleukin-10⁺ and interleukin-6^-interleukin-10⁺ cytokine patterns in ST-elevation acute myocardial infarction [J]. Circ Res, 2012,111(10):1336-1348.
11	Théroux P, Armstrong PW, Mahaffey KW, et al. Prognostic significance of blood markers of inflammation in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty and effects of pexelizumab, a C5 inhibitor: a substudy of the COMMA trial [J]. Eur Heart J, 2005,26(19):1964-1970.
12	Lindmark E, Diderholm E, Wallentin L, et al. Relationship between interleukin 6 and mortality in patients with unstable coronary artery disease: effects of an early invasive or noninvasive strategy [J]. JAMA,2001,286(17):2107-2113.
13	Cristell N, Cianflone D, Durante A, et al. FAMI Study Investigators.Highsensitivity C-reactive protein is within normal levels at the very onset of first ST-segment elevation acute myocardial infarction in 41% of cases: a multiethnic case-control study [J]. J Am Coll Cardiol,2011,58(25):2654-2661.
14	中华医学会心血管分会，中华心血管病杂志编辑委员会. 急性心肌梗死诊断和治疗指南[J]. 中华心血管病杂志, 2010,38(8):675-687.
15	中华医学会心血管分会，中华心血管病杂志编辑委员会. 不稳定性心绞痛和非ST 段抬高心肌梗死诊断和治疗指南[J]. 中华心血管病杂志, 2007,35(4):295-304.
16	Zheng Y, Wang Z, Deng L, et al. Osteopontin promotes inflammation in patients with acute coronary syndrome through its activity on IL-17 producing cells [J]. Eur J Immunol, 2012,42(10):2803-2814.
17	Ma YH, Yuan XL, Deng L, et al. Imbalanced frequencies of Th17 and Treg cells in acute coronary syndromes are mediated by IL-6-STAT3 signaling [J]. PLoS One, 2013,8(8):e72804.
18	Norata GD, Pirillo A, Ammirati E, et al. Emerging role of high density lipoproteins as a player in the immune system [J]. Atherosclerosis,2012,220(1):11-21.
19	Dominguez-Rodriguez A, Abreu-Gonzalez P, Garcia-Gonzalez M, et al. Prognostic value of interleukin-8 as a predictor of heart failure in patients with myocardial infarction and percutaneous intervention [J].Int J Cardiol, 2006,111(1):158-160.
20	Shibata M, Endo S, Inada K, et al. Elevated plasma levels of interleukin-1 receptor antagonist and interleukin-10 in patients with acute myocardial infarction [J]. J Interferon Cytokine Res,1997,17(3):145-150.
21	Dozio E, Malavazos AE, Vianello E, et al. Interleukin-15 and Soluble interleukin-15 receptor α in coronary artery disease patients:association with epicardial fat and indices of adipose tissue distribution[J]. PLoS One, 2014,9(1):e90960.
22	Ranjbaran H, Sokol SI, Gallo A, et al. An inflammatory pathway of IFN-gamma production in coronary atherosclerosis [J]. J Immunol,2007,178(1):592-604.
23	Cheng X, Yu X, Ding YJ, et al. The Th17/Treg imbalance in patients with acute coronary syndrome [J]. Clin Immunol, 2008,127(1):89-97.
24	Li Q, Wang Y, Chen K, et al. The role of oxidized low-density lipoprotein in breaking peripheral Th17/Treg balance in patients with acute coronary syndrome [J]. Biochem Biophys Res Commun,2010,394(3):836-842.
25	Zhao Z, Wu Y, Cheng M, et al. Activation of Th17/Th1 and Th1, but not Th17, is associated with the acute cardiac event in patients with acute coronary syndrome [J]. Atherosclerosis, 2011,217(2):518-524.
26	Liu Z, Lu F, Pan H, et al. Correlation of peripheral Th17 cells and Th17-associated cytokines to the severity of carotid artery plaque and its clinical implication [J]. Atherosclerosis, 2012,221(8):232-241.
27	Liuzzo G, Trotta F, Pedicino D. Interleukin-17 in atherosclerosis and cardiovascular disease: the good, the bad, and the unknown [J]. Eur Heart J, 2013,34(8):556-559.
28	Simon T, Taleb S, Danchin N, et al. Circulating levels of interleukin-17 and cardiovascular outcomes in patients with acute myocardial infarction [J]. Eur Heart J, 2013,34(8):570-577.
29	Korn T, Bettelli E, Oukka M, et al. IL-17 and Th17 Cells [J]. Annu Rev Immunol, 2009,27(9):485-517.
30	Jones SA, Scheller J, Rose-John S. Therapeutic strategies for the clinical blockade of IL-6/gp130 signaling [J]. J Clin Invest,2011,121(9):3375-3383.
31	Fujimoto M, Serada S, Mihara M, et al. Interleukin-6 blockade suppresses autoimmune arthritis in mice by the inhibition of inflammatory Th17 responses [J]. Arthritis Rheum, 2008,58(12):3710-3719.
32	Feldmann M, Williams RO, Paleolog E. What have we learnt from targeted anti-TNF therapy [J]. Ann Rheum Dis, 2010, 69 Suppl 1:i97-i99.

生化指标	HD组（n=20）	IL-6⁺AMI组（n=35）	IL-6^-AMI组（n=19）
hs-CRP（μg/L）	0.32（0.08～0.63）	8.43（1.28～10.75）^a，b	0.55（0.15～1.35）^a
TnI（μg/L）	0.012（0.009～0.020）	0.376（0.024～13.150）^a，b	0.002（0.001～0.044）^a
CK-MB（μg/L）	-	25.0（14.0～66.0）^b	11.5（8.8～17.0）
CHO（mmol/L）	4.58±0.52	4.02±1.35	3.82±0.99^a
TG（mmol/L）	1.06（0.80～1.51）	1.40（0.87～2.28）	1.53（1.26～1.95）
LDL（mmol/L）	2.61±0.60	2.46±0.71	2.27±0.57
HDL（mmol/L）	1.34±0.22	1.06±0.28^a	1.12±0.27^a
Cr（μmol/L）	61.66±17.92	78.92±22.44	72.21±29.72

生化指标	HD组（n=20）	IL-6⁺AMI组（n=35）	IL-6^-AMI组（n=19）
hs-CRP（μg/L）	0.32（0.08～0.63）	8.43（1.28～10.75）^a，b	0.55（0.15～1.35）^a
TnI（μg/L）	0.012（0.009～0.020）	0.376（0.024～13.150）^a，b	0.002（0.001～0.044）^a
CK-MB（μg/L）	-	25.0（14.0～66.0）^b	11.5（8.8～17.0）
CHO（mmol/L）	4.58±0.52	4.02±1.35	3.82±0.99^a
TG（mmol/L）	1.06（0.80～1.51）	1.40（0.87～2.28）	1.53（1.26～1.95）
LDL（mmol/L）	2.61±0.60	2.46±0.71	2.27±0.57
HDL（mmol/L）	1.34±0.22	1.06±0.28^a	1.12±0.27^a
Cr（μmol/L）	61.66±17.92	78.92±22.44	72.21±29.72

细胞因子	HD组（n=10）	IL-6⁺AMI组（n=10）	IL-6^-AMI组（n=10）
IL-6	5.89（1.01～12.63）	42.84（39.71～286.20）^a,b	11.12（7.12～19.40）^b
IL-17	3.83（2.06～8.00）	34.06（1.53～113.70）^b	42.03（27.57～92.62）^b
IL-10	8.28（1.45～11.60）	47.21（17.86～159.40）^a,b	7.44（4.11～44.38）
IFN-α	14.91（2.40～36.93）	66.16（4.92～170.60）^b	58.79（35.69～120.40）^b
IFN-β	4.82（0.10～15.62）	11.00（0.99～30.48）^a,b	27.91（14.31～42.08）^b
IL-12（40）	0.37（0.10～42.45）	1.98（0.10～18.12）	17.51（0.10～141.90）
IL-12（70）	3.32（0.10～21.54）	4.40（0.10～21.03）	13.72（0.10～19.25）
IL-13	0.10（0.10～2.96）	0.10（0.10～12.55）	7.37（0.10～46.61）
IL-15	0.41（0.10～2.56）	4.97（0.10～13.76）^a,b	0.10（0.10～13.60）
IL-1α	0.01（0.01～0.10）	NA	4.47（0.10～22.98）
IL-1β	NA	NA	0.10（0.10～5.23）
IL-2	0.89（0.36～2.32）	2.64（0.10～10.17）	8.22（0.84～18.79）
IL-4	NA	0.10（0.10～40.82）	0.10（0.10～7.32）
IL-5	0.01（0.01～0.45）	0.01（0.01～0.71）	0.40（0.01～4.57）
IL-7	0.01（0.01～36.90）	0.01（0.01～3.82）	0.01（0.01～16.49）
IL-8	9.90（5.40～12.71）	52.43（43.91～111.30）^a,b	39.82（29.16～46.95）^b
IL-9	0.31（0.01～4.11）	0.01（0.01～3.65）	3.60（0.01～21.91）
TNF-α	18.04（4.71～6.53）	28.89（18.44～40.83）^b	25.08（15.86～33.66）^b
TNF-β	0.01（0.01～0.24）	0.01（0.01～9.81）	0.01（0.01～0.52）
TGF-β	163.30（141.70～186.70）	413.10（15.40～2957.00）^b	576.20（25.23～2757.00）^b

细胞因子	HD组（n=10）	IL-6⁺AMI组（n=10）	IL-6^-AMI组（n=10）
IL-6	5.89（1.01～12.63）	42.84（39.71～286.20）^a,b	11.12（7.12～19.40）^b
IL-17	3.83（2.06～8.00）	34.06（1.53～113.70）^b	42.03（27.57～92.62）^b
IL-10	8.28（1.45～11.60）	47.21（17.86～159.40）^a,b	7.44（4.11～44.38）
IFN-α	14.91（2.40～36.93）	66.16（4.92～170.60）^b	58.79（35.69～120.40）^b
IFN-β	4.82（0.10～15.62）	11.00（0.99～30.48）^a,b	27.91（14.31～42.08）^b
IL-12（40）	0.37（0.10～42.45）	1.98（0.10～18.12）	17.51（0.10～141.90）
IL-12（70）	3.32（0.10～21.54）	4.40（0.10～21.03）	13.72（0.10～19.25）
IL-13	0.10（0.10～2.96）	0.10（0.10～12.55）	7.37（0.10～46.61）
IL-15	0.41（0.10～2.56）	4.97（0.10～13.76）^a,b	0.10（0.10～13.60）
IL-1α	0.01（0.01～0.10）	NA	4.47（0.10～22.98）
IL-1β	NA	NA	0.10（0.10～5.23）
IL-2	0.89（0.36～2.32）	2.64（0.10～10.17）	8.22（0.84～18.79）
IL-4	NA	0.10（0.10～40.82）	0.10（0.10～7.32）
IL-5	0.01（0.01～0.45）	0.01（0.01～0.71）	0.40（0.01～4.57）
IL-7	0.01（0.01～36.90）	0.01（0.01～3.82）	0.01（0.01～16.49）
IL-8	9.90（5.40～12.71）	52.43（43.91～111.30）^a,b	39.82（29.16～46.95）^b
IL-9	0.31（0.01～4.11）	0.01（0.01～3.65）	3.60（0.01～21.91）
TNF-α	18.04（4.71～6.53）	28.89（18.44～40.83）^b	25.08（15.86～33.66）^b
TNF-β	0.01（0.01～0.24）	0.01（0.01～9.81）	0.01（0.01～0.52）
TGF-β	163.30（141.70～186.70）	413.10（15.40～2957.00）^b	576.20（25.23～2757.00）^b

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