Serum Fas/FasL levels in dependence on clinical presentations of coronary disease and their relationship with risk factors

Abstract

Background/Aim. Ischemic heart disease is mostly a consequence of atherosclerosis. Besides the inflammation, the Fas/Fas ligand (FasL)/caspase death pathway is documented to be activated in atherosclerotic lesions. The aim of this study was to compare the values of soluble forms of Fas and FasL in patients with different presentations of coronary disease and to correlate Fas/FasL with risk factors. Methods. We studied 30 patients with chronic stable angina pectoris (SAP), 27 with non-stable angina pectoris (NSAP), and 39 with acute ST-elevation myocardial infarction (STEMI) and 27 age-matched healthy volunteers (the control group). Serum Fas/APO1 and FasL concentrations were determined using a commercially available enzymelinked immunoassays (ELISA). Results. Fas/APO-1 levels in the STEMI patients (6.981 ? 2.689 ng/mL) were significantly higher than Fas levels in the controls (5.092 ? 1.252 ng/mL, p < 0.01), but not significantly higher than Fas values in the SAP (5.952 ? 2.069 ng/mL) and the USAP patients (5.627?2.270 ng/ml). Levels of FasL did not show any significant difference among the studied groups. In the SAP patients Fas/APO1 showed a significant positive correlation with high sensitivity C-reactive protein (hsCRP) (p < 0.05) and a negative correlation with high-density lipoprotein cholesterol (HDL-C) (p < 0.05), while FasL showed a significant positive correlation with low-density lipoprotein cholesterol (LDL-C) (p < 0.05). Fas levels between the patients having cholesterol within normal range and those whose cholesterol was above the normal range showed a significant difference (p < 0.05) only in the NSAP patients. Fas and FasL levels between the patients with hsCRP lower than 3.0 mg/L and those with hsCRP higher than 3.0 mg/L of the SAP group showed a significant differences (p < 0.001, p < 0.05, respectively). Strong correlation between Fas concentration and diabetes mellitus (p < 0.05) and FasL concentrations and both cholesterol (p < 0.01) and triglycerides (p < 0.01) in the NSAP patients was observed. The patients in the SAP group showed no strong correlation between Fas and FasL concentration and risk factors. Conclusions. The obtained results showed that apoptotic process is dysregulated in the patients with ischemic heart disease. Interdependence between Fas and FasL and inflammatory and lipid markers as well as with cardiovascular risk factors was established.Uvod/Cilj. Ishemijska bolest srca je najcesce posledica ateroskleroze. Pored inflamacije, u aterogenezi je dokazana aktivnost spoljasnjeg puta apoptoze (Fas/FasL/kaspaza puta). Cilj ove studije bio je poredjenje nivoa Fas i FasL kod bolesnika sa razlicitom prezentacijom koronarne bolesti i korelisanje Fas/FasL s faktorima rizika. Metode. Ispitano je 30 bolesnika sa stabilnom anginom pektoris (SAP), 27 sa nestabilnom anginom pektoris (NSAP), 39 sa akutnim infarktom miokarda (AIM) i 27 zdravih osoba. Koncentracije Fas i FasL u serumu odredjivane su komercijalnim ELISA testovima. Rezultati. Koncentracije Fas kod bolesnika sa AIM (6,981 ? 2,689 ng/mL) bile su statisticki znacajno vise od koncentracija Fas ispitanika kontrolne grupe (5,092 ? 1,252 ng/mL, p < 0,01) i statisticki neznacajno vise od Fas nivoa u SAP i NSAP grupi. Kod ispitivanih grupa nije bilo statisticki znacajne razlike u vrednostima FasL. Kod bolesnika sa SAP postojala je znacajna pozitivna korelacija Fas i visoko senzitivnog Creaktivnog proteina (hsCRP) (p < 0,05), negativna korelacija Fas i lipoproteina velike gustine (HDL-C) (p < 0,05) i pozitivna korelacija FasL sa lipoproteinima niske gustine (LDL-C) (p < 0,05). Koncentracije Fas kod bolesnika sa normalnim i povisenim vrednostima holesterola znacajno su se razlikovale (p < 0,05) kod grupe NSAP. Vrednosti Fas i FasL kod bolesnika sa vrednostima hsCRP ispod 3,0 mg/L i onih sa hsCRP iznad 3,0 mg/L znacajno su se razlikovale u grupi SAP (p < 0,001, odnosno p < 0,05). Postojala je jaka korelacija koncentracije Fas i dijabetesa (p < 0,05) i koncentracije FasL i holesterola (p < 0,01) i triglicerida (p < 0,01) u grupi NSAP. U grupi SAP nije postojala znacajna korelacija koncentracija Fas i FasL i faktora rizika. Zakljucak. U ishemijskoj bolesti srca postoji medjuzavisnost Fas/FasL i inflamatornih i lipidnih markera, kao i faktora rizika od koronarne bolesti.