scholarly journals Toll-like receptor 2 and 4 stimulation elicits an enhanced inflammatory response in human obese patients with atherosclerosis

2011 ◽  
Vol 121 (5) ◽  
pp. 205-214 ◽  
Author(s):  
Vincent P.W. Scholtes ◽  
Dik Versteeg ◽  
Jean-Paul P.M. de Vries ◽  
Imo E. Hoefer ◽  
Arjan H. Schoneveld ◽  
...  

The innate immune response elicited by activation of TLRs (Toll-like receptors) plays an important role in the pathogenesis of atherosclerosis. We hypothesized that cardiovascular risk factors are associated with the activation status of the innate immune system. We therefore assessed the responsiveness of TLRs on circulating cells in two groups of patients with established atherosclerosis and related this to the presence of cardiovascular risk factors. TNF (tumour necrosis factor)-α release induced by TLR2 and TLR4 activation was measured in patients with established coronary [PCI (percutaneous coronary intervention) study, n=78] or carotid artery disease [CEA (carotid endarterectomy) study, n=104], by stimulating whole blood samples with lipopolysaccharide (TLR4 ligand) and Pam3CSK4 [tripalmitoylcysteinylseryl-(lysyl)4; TLR2 ligand]. As an early activation marker, CD11b expression was measured by flow cytometry on CD14+ cells. Obesity was the ‘only’ risk factor that correlated with the TLR response. In both studies, obese patients had significantly higher TNF-α levels after stimulation of TLR2 compared with non-obese patients [16.9 (7.7–49.4) compared with 7.5 (1.5–19.2) pg/ml (P=0.008) in coronary artery disease and 14.6 (8.1–28.4) compared with 9.5 (6.1–15.7) pg/ml (P=0.015) in carotid artery disease; values are medians (interquartile range)]. Similar results were obtained following TLR4 stimulation. The enhanced inflammatory state in obese patients was also confirmed by a significant increased expression of the activation marker CD11b on circulating monocytes. In conclusion, obesity is associated with an enhanced TLR response in patients suffering from established atherosclerotic disease.

Author(s):  
Vitorino Modesto dos Santos ◽  
Laura Campos Modesto

Albers SS et al. reviewed carotid artery variation in the development of atherosclerotic carotid artery disease (Int J Med Students. 2019 Sep-Dec;7(3):82-91) commenting on changes from birth to older ages that can contribute to disorders of intramural elastin even in absence of disease. Considering the coexistence of traditional risk factors of atherosclerosis, additional comments are posed about measurements of carotid intima-media thickness in patients with obesity, chronic renal failure, and secondary hyperparathyroidism. The authors emphasized the need for further research to validate preventive procedures initiating since prenatal.


VASA ◽  
2009 ◽  
Vol 38 (4) ◽  
pp. 357-364 ◽  
Author(s):  
Giannoukas ◽  
Sfyroeras ◽  
Griffin ◽  
Saleptsis ◽  
Antoniou ◽  
...  

Background: Severity of stenosis remains the main factor for assessing risk of stroke in patients with internal carotid artery (ICA) disease. This study was conducted to investigate the association of plaque echostructure and other established and emerging cardiovascular risk factors with symptomatic ICA disease. Design: Cross-sectional study of consecutive patients with significant (> 50 %) ICA stenosis. Patients and methods: Carotid plaque echostructure, smoking, hypertension, diabetes mellitus, serum lipoprotein (a), homocysteine, vitamin B12, folate, cholesterol to high-density lipoprotein ratio, triglycerides, C-reactive protein, and the Framingham risk score were assessed in 124 consecutive patients (70 asymptomatic; 54 symptomatic) with significant (> 50 %) ICA stenosis. Results: The asymptomatic and symptomatic groups did not differ in terms of gender distribution (p = 0.76) and severity of stenosis (p = 0.62). Echolucent plaques (type 1 and 2) were more predominant in patients with symptomatic disease (p = 0.004, OR = 2.13, 95 % CI = 1.26-3.6). Patients with plaques type 1 were relatively younger than those with type 4 (p = 0.02). None of the other factors assessed had any significant association with symptomatic disease and any type of carotid plaque. Conclusions: Besides the severity of carotid stenosis, the presence of an echolucent plaque appears as an important factor associated with symptomatic ICA disease. Also, young patients are more likely to have an echolucent plaque suggesting an age-related association with plaque maturation.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Kolossvary ◽  
E.K Fishman ◽  
G Gerstenblith ◽  
D.A Bluemke ◽  
R.N Mandler ◽  
...  

Abstract Background/Introduction Cross-sectional studies are inconsistent on the potential independent adverse effects of human immunodeficiency virus (HIV)-infection on coronary artery disease (CAD). Furthermore, there is no information on the potential effects of HIV-infection on plaque volumes. Also, only the independent effects of HIV-infection on CAD have been investigated. Purpose In a prospective longitudinal observational cohort, we wished to assess whether HIV-infection accelerates CAD independently, or by acting in synergistic fashion with conventional and nonconventional cardiovascular risk factors to accelerate disease progression as assessed by clinical and volumetric parameters of CAD on coronary CT angiography (CCTA). Methods Overall, 300 asymptomatic individuals without cardiovascular symptoms but with CCTA-confirmed coronary plaques (210 males, age: 48.0±7.2 years) with or without HIV (226 HIV-infected) prospectively underwent CCTA at two time points (mean follow-up: 4.0±2.3 years). Agatston-score, number of coronary plaques, segment stenosis score were calculated, and we also segmented the coronary plaques to enumerate total, noncalcified (−100–350HU) and calcified (≥351HU) plaque volumes. Linear mixed models were used to assess the effects of HIV-infection, atherosclerotic cardiovascular disease (ASCVD) risk, years of cocaine use and high-sensitivity C-reactive protein on CCTA markers of CAD. Results In univariate analysis, there was no significant difference in CAD characteristics between HIV-infected and -uninfected, neither at baseline nor at follow-up (p>0.05 for all). Furthermore, there was no significant difference in annual progression rates between the two groups (p>0.05 for all). By multivariate analysis, HIV was not associated with any CAD parameter (p>0.05 for all). However, among HIV-infected individuals, each year of cocaine use significantly increased all CAD parameters (p<0.05 for all), while ASCVD risk score was significantly associated with CAD parameters except for Agatston-score (p<0.05). These associations were only present among HIV-infected individuals. Conclusion(s) Instead of directly worsening CAD, HIV may promote CAD through increased susceptibility to conventional and nonconventional cardiovascular risk factors. Therefore, aggressive management of both conventional and nonconventional cardiovascular risk factors is needed to reduce cardiovascular burden of HIV-infection. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health, National Institute on Drug Abuse


2021 ◽  
Vol 8 (11) ◽  
pp. 608-612
Author(s):  
Sunil S. Thanvi ◽  
Sunil K. Karna ◽  
Utsav B Patel

BACKGROUND Routine screening of healthy individuals for the presence of cardiovascular risk factors is important for identification of high-risk coronary artery disease (CAD) patients at early stage and to provide preventive care. Considering the high burden of CAD, such investigations are of significant importance in Indian context. METHODS In this cross-sectional study, adult individuals (18 – 68 years) were evaluated for pre-existing diseases, lipid profile, blood glucose profile, thyroid profile, haemoglobin (Hb) and vitamins D3 and B12 levels after obtaining informed consent. These variables were compared between patients stratified based on their gender and age (< 40, 40 – 60, > 60 years). RESULTS A total of 1,508 participants (mean age: 49 ± 11 years; 49.9 % females) were investigated. Hypertension, diabetes, dyslipidaemia, anaemia, vitamin D3 and B12 deficiencies, hyperthyroidism, and hypothyroidism were observed in 31.2 %, 26.5 %, 32.0 %, 8.6 %, 35.3 %, 25.1 %, 21.0 % and 0.6 % of patients respectively. Prevalence of hypertension, diabetes, and dyslipidaemia increased with ageing, while deficiencies of Hb, vitamin D3, and vitamin B12 as well as hyperthyroidism and hypothyroidism were comparable across all age groups. Males were more prone to hypertension, diabetes, and dyslipidaemia, while females were more prone to have Hb deficiency, hyperthyroidism, and hypothyroidism. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), fasting blood sugar (FBS), vitamin D3, and vitamin B12 were elevated with increase in age, while Hb levels decreased. Males exhibited higher levels of TG, low-density lipoprotein cholesterol (LDL-C), TC / HDL, LDL / HDL, FBS, and Hb, while females displayed higher levels of vitamin D3 and B12. CONCLUSIONS Our findings verify the role of age and gender on majority of cardiovascular risk factors. The high prevalence of cardiovascular risk factors is alarming and demands the need for appropriate health-care measures. KEYWORDS Age, Coronary Artery Disease, Gender, Risk Factor


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