Serum interleukin-6 is elevated in symptomatic carotid bifurcation disease

Koutouzis, Michael; Rallidis, Lοukianos S.; Peros, George; Nomikos, Alexandros; Tzavara, Vassiliki; Barbatis, Calypso; Andrikopoulos, Vasilios; Vassiliou, John; Kyriakides, Zenon S.

doi:10.1111/j.1600-0404.2008.01068.x

Cited by 33 publications

(18 citation statements)

References 44 publications

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“…The connection of high serum concentrations of IL-6 and TNF-α with the presence of unstable plaques assessed in ultrasound examinations has been confirmed by other authors as well [15, 25, 27]. In the present study, no significant differences in TNF-α serum levels depending on the presence of stenosis, its level or clinical manifestation were found, which is in agreement with the results obtained by other authors [23, 28]. …”

Section: Discussionsupporting

confidence: 93%

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Inflammatory markers in patients with internal carotid artery stenosis

Puz¹,

Lasek–Bal²,

Ziaja³

et al. 2013

aoms

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IntroductionAvailable reports underline the significance of the inflammatory process in the development, progression and destabilisation of atherosclerotic plaques in the internal carotid artery (ICA). The aim of this study was to evaluate the relationship between the degree of ICA stenosis, ultrasound plaque morphology and serum concentration of selected inflammatory markers.Material and methodsSixty-five patients with ICA stenosis > 50% (39 symptomatic) and 30 healthy volunteers were enrolled in the study. Clinical, neurological examination and laboratory evaluation (leucocyte count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen, tumour necrosis factor-α (TNF-α), interleukins (1β, 6 and 10), anti-cytomegalovirus IgG antibody titre) were performed. Stenosis grade ≥ 70%, ulcerations on the plaque surface and a hypoechoic (or predominantly hypoechoic) structure of the plaque, obtained by colour-coded duplex examination, were accepted as the characteristics of unstable stenoses.ResultsUnstable ultrasound features of ICA stenosis were found significantly more often in symptomatic than in asymptomatic patients (71.79% vs. 30.71% for stenosis degree ≥ 70%, p = 0.001 and 61.23% vs. 38.46% for unstable plaque morphology, p = 0.01). Patients with ICA stenosis had significantly higher serum concentrations of interleukin-6, fibrinogen, ESR and higher CRP values than the individuals from the control group (p = 0.001, p = 0.009, p = 0.036, p = 0.009 respectively). Patients with unstable plaques structure had significantly higher concentrations of TNF-α, interleukin-6, fibrinogen, higher number of leukocytes, monocytes and higher CRP values than patients with stable plaques (p = 0.008, p = 0.049, p = 0.012, p = 0.0002, p = 0.006, p = 0.0003 respectively). No significant differences in above-mentioned parameters between the groups with stenosis < 70% and ≥ 70% were found.ConclusionsThere is a relationship between the activity of the selected inflammatory markers in serum and atherosclerotic unstable internal carotid artery stenosis. There is no relationship between serum concentration of inflammatory markers and degree of carotid artery stenosis.

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Section: Discussionsupporting

confidence: 93%

“…Only some of them concern their participation in the development of atherosclerotic ICA stenosis [7, 8, 13, 15, 23–26]. …”

Section: Discussionmentioning

confidence: 99%

Inflammatory markers in patients with internal carotid artery stenosis

Puz¹,

Lasek–Bal²,

Ziaja³

et al. 2013

aoms

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“…2). Thus, the findings of the present study in an unselected population of CS subjects on contemporary pharmacotherapy are unable to confirm the clinical utility of several circulating biomarkers that have previously been suggested to indicate the symptomatic status of CS, including hsCRP,4,5 IL-6,4,21 Lp(a),4 and MMPs 4,6. Moreover, this analysis did not demonstrate the utility of several other classic (e.g., CD40L, sVCAM, fibrinogen, IL-1β, IL-8, IL-18, MPO, and MCP-1)4,11 and novel (e.g., visfatin and leptin/adiponectin)7,9,22 circulating biomarkers of atherosclerotic plaque destabilization and rupture.…”

Section: Discussioncontrasting

confidence: 91%

Multimarker Approach in Discriminating Patients with Symptomatic and Asymptomatic Atherosclerotic Carotid Artery Stenosis

et al. 2013

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Background and PurposezzSeveral circulating biomarkers have been implicated in carotid atherosclerotic plaque rupture and thrombosis; however, their clinical utility remains unknown. The aim of this study was to determine the role of a large biomarker panel in the discrimination of symptomatic (S) vs. asymptomatic (A/S) subjects in a contemporary population with carotid artery stenosis (CS).MethodszzProspective sampling of circulating cytokines and blood lipids was performed in 300 unselected, consecutive patients with ≥50% CS, as assessed by duplex ultrasound (age 47-83 years; 110 with A/S and 190 with S) who were referred for potential CS revascularization.ResultszzCS severity and pharmacotherapy did not differ between the A/S and S patients. The median values of total cholesterol, low-density lipoprotein cholesterol, and lipoprotein(a) did not differ, but high-density lipoprotein (HDL) cholesterol was significantly higher (p<0.001) and triglycerides were lower (p=0.03) in the A/S-CS group than in the S-CS group. Interleukin-6 (IL-6) and high-sensitivity C-reactive protein were higher (p=0.04 and p=0.07, respectively) in the S-CS group. Circulating visfatin, soluble CD 40 receptor ligand, soluble vascular cell adhesion molecule, leptin, adiponectin, IL-1β, IL-8, IL-18, monocyte chemoattractant protein-1, myeloperoxidase, matrix metalloproteinases-8, -9, and -10, and fibrinogen were similar, but tissue inhibitor of matrix metalloproteinases-1 (TIMP) was reduced in S-CS compared to A/S-CS (p=0.02). Nevertheless, incorporation of TIMP and IL-6 did not improve the HDL-cholesterol receiver operating characteristics for S-CS status prediction. S-CS status was unrelated to angiographic stenosis severity or plaque burden, as assessed by intravascular ultrasound (p=0.16 and p=0.67, respectively). Multivariate logistic regression analysis revealed low HDL-cholesterol to be the only independent predictor of CS symptoms, with an odds ratio of 1.81 (95% confidence interval=1.15-2.84, p=0.01) for HDL <1.00 mmol/L (first quartile) vs. >1.37 (third quartile). In S-CS, osteoprotegerin and lipoprotein-associated phospholipase A2 (Lp-PLA 2 ) were elevated in those with recent vs. remote symptoms (p=0.01 and p=0.02, respectively).ConclusionszzIn an all-comer CS population on contemporary pharmacotherapy, low HDLcholesterol (but not other previously implicated or several novel circulating biomarkers) is an independent predictor of S-CS status. In addition, an increase in circulating osteoprotegerin and Lp-PLA2 may transiently indicate S transformation of the carotid atherosclerotic plaque.

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“…The clinical role of plasmatic biomarkers in the setting of carotid atherosclerosis has been extensively studied in these recent years [17][18][19] . This not only for the assessment of the embolic risk but also for the choice of the best type of carotid intervention [20][21][22] .…”

Section: Discussionmentioning

confidence: 99%

Plasmatic biomarkers of inflammation correlate with 18FDG-PET-CT and microembolic signals in patients with carotid stenosis

Mueller¹,

Fisch²,

Bonvin³

et al. 2018

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Methods:18 FDG-PET-CT and MES detection was performed in consecutive patients with 50% to 99% symptomatic or asymptomatic carotid stenosis. Uptake index was defined by a target to background ratio (TBR) between maximum standardized uptake value of the carotid plaque and the average uptake of the jugular veins. The analysis of biomarkers included adhesion molecules [intercellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule 1, P-selectin and E-selectin], interleukins (IL-1, IL-6), chemokines (RANTES, monocyte chemoattractant protein 1), cytokines (tumor necrosis factor α), matrix-metalloproteases (MMP), myeloperoxidase, and lipoprotein-associated phospholipase A2.Results: There were 54 symptomatic and 57 asymptomatic patients. TBR values were significantly higher in the symptomatic compared to the asymptomatic (median 2.1 vs . 1.8, P = 0.002) and in the MES positive (MES+) compared to the MES negative (MES-) group (MES+, n = 19, median 2.3 and MES-, n = 88, median 1.8, P = 0.01). The best threshold for TBR values was of 1.9. We found a significant correlation between higher 18 FDG uptake (TBR ≥ 1.9) and the plasmatic levels of chemokine RANTES (P = 0.03) and higher levels of ICAM-1 in MES+ patients (P = 0.03). Interestingly MMP-2 levels were more important in patients with lower TBR values (P = 0.02) and MMP-3 and P-selectin in those who were MES-(respectively P = 0.001 and P = 0.009). Conclusion:In the present study, ICAM-1 was associated with the presence of thrombotically active atherosclerotic plaques, while RANTES mainly correlated with the inflammatory process. MMP-2, MMP-3 and P-selectin levels were more important in patients with stable plaques.

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Serum interleukin-6 is elevated in symptomatic carotid bifurcation disease

Cited by 33 publications

References 44 publications

Inflammatory markers in patients with internal carotid artery stenosis

Inflammatory markers in patients with internal carotid artery stenosis

Multimarker Approach in Discriminating Patients with Symptomatic and Asymptomatic Atherosclerotic Carotid Artery Stenosis

Plasmatic biomarkers of inflammation correlate with 18FDG-PET-CT and microembolic signals in patients with carotid stenosis

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