Introduction. The present study evaluated the interaction of statin response and genetic polymorphism of interleukin (IL-1β, IL-6, IL-4, IL-10) genes with the course of atherosclerosis and coronary heart disease (CHD) in patients with CHD combined with acute respiratory viral infections (ARVI). Objectives. Studying variability of Rosuvastatin response in patients with CHD combined with ARVI, taking cytokine gene polymorphism into account. Materials and methods. Detection of lipid metabolism parameters and interleukin levels in blood serum; verification of causative agents of the infectious process. Genotyping of polymorphisms IL-1β –511C>T, IL-6 –174G>C, IL-4 –589C>T, IL-10 –1082G>А. Statistical processing in Microsoft Office Excel 2007 software. Results and discussion. In CHD patients at Visit I, the target level of low-density lipoprotein cholesterol (LDL-C) was reached by 55.7% of participants. At Visit II, the target LDL-C level was reached by 49.7% of patients, which coincided with ARVI detection in some patients. In CHD patients with ARVI at Visit II, the IL-1β level increased to 33.00 pg/ml (N=5.00 pg/ml), IL-6 – 19.20 pg/ml (N=9.00 pg/ml); at Visit VI those levels decreased to 20.70 pg/ml and 12.80 pg/ml. The IL-4 level was 8.30 pg/ml (N=13.00 pg/ml), while IL-10 level was 19.40 pg/ml (N=31.00 pg/ml), with their increase at Visit VI to 15.80 pg/ml and 33.50 pg/ml. CHD patients without ARVI did not develop interleukin level changes. At Visit II, the IL-1β level was 10.30 pg/ml, IL-6 level was 12.40 pg/ml, and at Visit VI, they were 13.00 pg/ml and 14.00 pg/ml. The IL-4 and IL-10 levels at Visit II were 19.70 pg/ml and 32.30 pg/ml; at Visit VI, those levels were 23.20 pg/ml and 34.20 pg/ml. The following associations were demonstrated: –511CT / increased IL-1β, LDL-C synthesis; –511СС / LDL-C level increase; –174GG / IL-6, LDL-C level increase; –1082GG / IL-10 level increase, cholesterol and CRP level decrease; –589ТТ / CRP, IL-4 level increase. Conclusion. Genotypes –511CT, –174GG, –1082AA in all patients required 20 mg/day Rosuvastatin dose to reach the target LDL-C level.
Аннотация. Оценка изменений липидного профиля пациентов в двух изучаемых группах (больные ишемической болезнью сердца (ИБС) с острой респираторной вирусной инфекцией (ОРВИ)) и больные ИБС без ОРВИ показала, что 6% больных ИБС после верификации у них ОРВИ потеряли достигнутый на амбулаторном этапе наблюдения целевой уровень холестерина. Среди больных ИБС без проявления ОРВИ достигнутый целевой уровень составил-53%. Цитокиновый статус больных характеризовался повышением провоспалительных цитокинов (IL-1β и IL-6) у больных ИБС при присоединении ОРВИ на II визите до 33,1 пг/мл и 29,4 пг/мл соответственно с дальнейшим снижением к 12-й неделе до 16,8 пг/мл и14,8 пг/мл. Пациенты с ИБС показали стабильный уровень про-и противовоспалительных цитокинов без динамических изменений на всех этапах наблюдения, что характеризует баланс процессов воспаления при хронической ИБС. Проведенное с целью персонализации фармакологической коррекции гиперлипидемии (ГЛП) изучение вклада генетического полиморфизма генов про-и противовоспалительных цитокинов в выраженность гиполипидемического ответа у больных ИБС в условиях ОРВИ показало, что при носительстве генотипа-511CT гена IL-1β,-174GG гена IL-6 и генотипа-1082AA гена IL-10 для достижения целевого холестерина требовалась доза розувастатина-20 мг/сут.
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