Interleukin 6 expression in coronary circulation after coronary angioplasty as a risk factor for restenosis

Abstract

Objective-To investigate changes in cytokine expression in the coronary circulation induced by percutaneous transluminal coronary angioplasty (PTCA). Methods-The study involved 32 patients with ischaemic heart disease who underwent elective PTCA for isolated stenotic lesions of the left coronary artery. Ten patients had plain old balloon angioplasty, 10 had percutaneous transluminal rotational atherectomy, and 12 had stent implantation. Blood samples were drawn from the coronary sinus before and immediately after PTCA. Plasma concentrations of interleukin 6 (IL-6), platelet derived growth factor (PDGF), monocyte chemoattractant protein 1 (MCP-1), and macrophage coronary stimulating factor (M-CSF) were measured. The patients were scheduled for follow up angiography six months after PTCA. Late loss index was calculated using quantitative coronary angiography. Results-IL-6 concentrations in coronary sinus blood increased immediately after PTCA (p < 0.001), but there was no change in PDGF, MCP-1, or M-CSF. There was a positive correlation between changes in IL-6 concentrations immediately after PTCA and late loss index six months after PTCA (r = 0.73, p < 0.001). IL-6 concentrations in coronary sinus blood were higher in patients with late restenosis than in those without restenosis (p < 0.001). Conclusions-PTCA induces IL-6 production in the coronary circulation. This may induce subsequent inflammatory responses in injured vessels and play an important role in late restenosis after PTCA. (Heart 2000;84:83-87)

Serotonin Increases Interleukin-6 Synthesis in Human Vascular Smooth Muscle Cells

“…Recently, we reported that IL-6 levels in the coronary sinus blood became significantly elevated after PTCA and that a positive significant correlation was observed between increased IL-6 levels and late restenosis. 50 From these findings, we are tempted to speculate that, in addition to its direct effects on vascular smooth muscle contraction and growth, 5-HT secreted from activated platelets may promote the initiation or progression of coronary atherosclerosis by activating IL-6 -mediated inflammatory processes in the vascular tissue. However, to prove our premise, further studies are necessary to determine whether 5-HT plays an inflammatory as well as thrombotic role in experimental models or patients with coronary artery disease.…”

Plasma Levels of Soluble Thrombomodulin, C-reactive Protein, and Serum Amyloid A Protein in the Atherosclerotic Coronary Circulation

“…There is an interesting report that the concentration of IL-6, a major inducer of CRP and SAA synthesis, in the CS increased immediately after PTCA and was higher in patients with late restenosis than in those without restenosis. 20) An elevated sino-arterial difference in the levels of IL-6 was reported in patients with acute coronary syndrome. 21) Thus, pro-inflammatory cytokines can be released by atherosclerotic coronary arteries.…”

The cell cycle: A critical therapeutic target to prevent vascular proliferative disease

“…This includes P-selectin and integrins such as beta 2 -integrin Mac-1 (CD11b/CD18) (17). Local production of cytokines (eg, interleukin [IL]-1, IL-6 and tumour necrosis factor-alpha [TNF-α]) by activated macrophages, VSMCs and endothelial cells also play a major role in inducing an inflammatory reaction at the site of injury (18)(19)(20). Increased neointimal macrophage infiltration correlates with the extent of neointima formation in humans (21).…”