Pro and antiinflammatory cytokines in unstable angina

ABSTRACT

Recent studies suggest that inflammation may play an important role in the pathogenesis of acute coronary syndromes. Several inflammav tory markers are increased in acute coronary syndromes as the nonspecific hepatically synthesized CRP, instead, several cytokines are direct inflammatory mediators as lL-6 and TNF-alpha which increase in many disease states, including the acute coronary syndromes. lL-10 is an anti-inflammatory cytokine, is produced by Th2 lymphocytes, B cells, and monocytes. It inhibits macrophagedependent cytokine synthesis by Th1 cells thus regulate balance between ceII-and humeral-mediated immune response. The proinflammatory cytokines play a role in acute coronary syndrome. however. the potential role of anti-inflammatory cytokines in the modulation of atherosclerotic process remains unknown. The objective of this study is to assess the value of pro and entiinilammatory cytokines in patients with unstable angina. The present work assessed the serum level of proinflammatory cytokines lL-6 and TNF-alpha and anti-inflammatory cytokine lL-10 in 36 patients, 20 patients had chronic stable angina, their ages ranged between 48-62 years with mean age 53 years and 16 patients with unstable angina class IIIB according to Braunwald classification, their ages ranged between 4861 years and their mean age is 54 years. All patients were diagnosed by coronary angiography. A control group comprise 10 subjects oi matched age and sex also included in this study. Serum lL-6 end TNF-alpha show a highly significant elevation in unstable angina versus the other two groups [P<0.001], these proinflammatory cytokines are positively correlated with serum cholesterol, LDL-c. TG and negatively correlated with mm in whole groups. Serum anti-inflammatory cytokine IL-10 shows a highly significant decrease in patients with unstable angina when compared to the control group [P=0.002] and also shows significant decrease when compared to patients with stable angina group [P=0.02]. Also serum lL-10 shows a negative correlation with lL-6, TNF-alpha, serum cholesterol, LDL-c, TG and PPBS in whole groups. These results indicate that the level at antiinlammatory cytokine lL-10 decrease in patients with unstable angina and this decrease may be the cause of plaque instability and rupture