ABSTRACT
OBJECTIVE AND DESIGN: It is believed that the magnitude of the systemic inflammatory response induced by percutaneous coronary intervention (PCI) impacts on the long-term outcomes in patients with stable angina (SA) and unstable angina (UA). We aimed to determine whether an inflammatory response appears in in-stent restenosis (ISR) patients undergoing balloon angioplasty and to assess its pattern and magnitude in relation to SA and UA subjects. SUBJECTS: 80 patients (59 with SA, 10 with UA, 11 with ISR) were enrolled into the prospective study. TREATMENT: SA and UA patients undergoing single vessel coronary balloon angioplasty followed by stenting versus ISR subjects in whom only balloon angioplasty was performed. METHODS: C-reactive protein (CRP), serum amyloid A (SAA), tumor necrosis factor alpha (TNF-alpha) and interleukin 10 (IL-10) were measured in blood samples collected before and 6, 24 h and 1 month after the procedure. RESULTS: A comparable pattern of inflammatory response in terms of CRP and SAA concentrations in subjects undergoing PCI due to ISR and SA was discovered while in unstable patients its magnitude was substantially higher. CRP and SAA levels increased significantly in each group with the peak value at 24 h and the baseline levels remarkably correlated with the highest markers' concentrations. In contrast, preprocedural TNF-alpha concentrations were higher in ISR group when compared with SA and UA patients. Additionally, in ISR group a twofold increase in their values of borderline significance at 6 h was noted. SA and UA subjects were found to have significantly lower TNF-alpha levels at 6 and 24 h after the intervention though the marker concentrations markedly increased with peak values at 1 month. The levels of IL-10 did not differ at any time point between the groups. CONCLUSIONS: We suggest that PCI triggers a systemic inflammatory response in patients with ISR and considerable differences in its pattern when compared with SA and UA patients were demonstrated. Moreover, a high preprocedural TNF-alpha level and its increase provoked by PCI in the ISR group warrant the need for further investigation of its possible involvement in the restenosis process.
Subject(s)
Angina Pectoris/blood , Angina, Unstable/blood , Angioplasty, Balloon, Coronary/methods , Coronary Restenosis , Inflammation , Angioplasty, Balloon/methods , C-Reactive Protein/biosynthesis , Coronary Artery Disease , Female , Humans , Interleukin-10/blood , Male , Serum Amyloid A Protein/biosynthesis , Stents , Time Factors , Treatment Outcome , Tumor Necrosis Factor-alpha/biosynthesis , Tumor Necrosis Factor-alpha/metabolismABSTRACT
The aim of the study was to assess the compatibility of IgA antiendomysium antibodies (IgAEmA) and IgA tissue transglutaminase antibodies (IgAtTG) in treated patients with coeliac disease and to estimate the value of the IgAtTG-ELISA as a marker of gluten-free diet maintenance. The study included 71 children and young adults (46 F, 25 M) aged from 6 years to 27 years, on the gluten-free diet (in some cases unrestricted) for at least 4 years because of coeliac disease diagnosed according to ESPGHAN criteria. Serum samples of all patients were examined simultaneously for IgAEmA titer by indirect immunofluorescence and IgAtTG level by ELISA test. IgAEmA antibodies were present in 26 patients (36.6%). IgAtTG-ELISA were positive in 23 patients (32.4%), equivocal--in 8 patients (11.3%) and negative--in 40 patients (53.6%). The serological tests were compatible in 58 patients (81.7%). If we consider equivocal results of IgAtTG test to be negative, IgAEmA and IgAtTG tests will be compatible in 64 cases (90.1%). Tissue transglutaminase antibodies ELISA provide a sensitive test of the gluten-free diet maintenance in patients with coeliac disease.
