Objective-We examined the role of the CXCR2 ligand growth-related oncogene (GRO) ␣ in human atherosclerosis. Methods and Results-GRO␣ levels were examined by enzyme immunoassay, real-time quantitative RT-PCR, and cDNA microarrays. The in vitro effect of statins on GRO␣ was examined in endothelial cells and THP-1 macrophages. Our main findings were: (1) GRO␣ was among the 10 most differentially expressed transcripts comparing peripheral blood mononuclear cells (PBMCs) from patients with coronary artery disease (CAD) and healthy controls. (2) Both patients with stable (nϭ41) and particularly those with unstable (nϭ47) angina had increased plasma levels of GRO␣ comparing controls (nϭ20). (3) We found increased expression of GRO␣ within symptomatic carotid plaques, located to macrophages and endothelial cells. Key Words: atherosclerosis Ⅲ chemokines Ⅲ inflammation Ⅲ endothelium C oronary artery disease (CAD) is a chronic progressive disorder where the pathogenesis is multifactorial and involves lipid deposition, thrombus formation, matrix degradation, and inflammation. In all steps of this process, regulation by inflammatory cytokines seems to play a central role, but there are still issues to be clarified, and the precise mechanisms of action of each of the inflammatory participants have not been elucidated. 1 Chemokines are thought to be important actors in the inflammatory process characterizing atherogenesis and plaque destabilization. Thus, increased expression of IL-8 2 and monocyte chemoattractant protein (MCP)-1 3 has been found within atherosclerotic plaques in humans, and targeted disruption of the genes for MCP-1, 4 CCR2 (ie, MCP-1 receptor), 5 and CXCR2, 6 which binds IL-8, significantly decreases atherosclerotic lesion formation in mice prone to developing atherosclerosis. CXCR2 is 1 of 2 functional IL-8 receptors that also bind other CXC chemokines like growthrelated oncogene (GRO)␣. As no murine IL-8 homologue has been described, 7 but disruption of CXCR2 ameliorates murine atherosclerosis, we believe that other CXCR2 ligands are of importance in this process. This hypothesis is strengthened by the observation that GRO␣ rather than MCP-1 promotes monocyte arrest in inflamed endothelium in apolipoprotein E Ϫ/Ϫ mice. 8 However, although there are several reports on IL-8 in human CAD, few studies have examined the role of other CXCR2 ligands in human atherosclerosis.In the present study, we identified GRO␣ as a potentially important mediator of atherogenesis by using DNA microarrays to identify transcripts for cytokines in peripheral blood mononuclear cells (PBMCs) that were differently expressed in CAD patients and healthy controls. We further examined the possible role of this CXC chemokine in atherosclerosis by several approaches including clinical studies in CAD patients and experimental studies in cells with relevance to atherogenesis. We also examined the
Materials and Methods
Patients and ControlsIn the initial screening experiments with DNA microarrays and subsequent real-time RT-PCR analyses,...