Soluble CD44 and iInterleukin-10 as immuno-inflammatory mediators in patients with stable and unstable angina : diagnostic and prognostic value

الملخص EN

Convincing evidence suggests that atherosclerosis is an inflammatory disease.

The inflammatory response is an important determinant of atherosclerotic plaque instability.

In this study, the serum levels of the pro-inflammatory mediator sCD44 and the anti-inflammatory cytokine IL-10 were measured in patients with stable and unstable angina and their values were correlated with some predictors of adverse cardiac events in patients with unstable angina namely cardiac troponin T, C-reactine protein (CRP), ischemic ST-segment changes during 24-hours ambulatory ECG and echocardiographic ally measured wall motion score index (WMSI).

The study was conducted on 15 patients with stable angina (SA), 22 patients with Braun Wald class III B unstable angina (UA) and 10 healthy subjects as a control group.

The mean serum levels of sCD44 and IL-10 were 373.6 ± 110 ng /mL and 33.1 ± 6.2 pg /mL in SA group, 476.7 ± 162.2 ng /mL and 24.4 ± 3.5 pg /mL in UA group and 262.9 ± 81.4 ng /mL and 37.3± 4.9 pg /ml in control group.

Serum sCD44 was significantly higher and serum IL-10 was significantly lower in stable and unstable angina groups compared to controls and in UA group compared to SA group.

In UA group, serum sCD44 was higher and serum IL-10 was lower in troponin positive patients, patients with ischemic ST episodes and patients with high WMSI compared to troponin negative patients, patients without ischemic ST episodes and patients with low WMSI.

Serum sCD44 was positively correlated with CRP level (r = 0.703, p< 0.001) and the number of ischemic episodes (r = 0.539, p < 0.05) and negatively correlated with ST-segment level (r= - 0.688, p<0.01) while serum IL-10 was negatively correlated with CRP level (r = - 0.56, p < 0.01) and the number of ischemic episodes (r = - 0.534, p < 0.05)and positively correlated with ST-segment level (r = 0.581, p < 0.05).

It was concluded that, patients with stable and unstable angina have imbalance between sCD44 and IL-10 with increase in sCD44 and decrease in IL-10 which is more manifest in patients with UA suggesting an atherogenic and plaque in stabilizing role for sCD44 and an anti-atherogenic and plaque stabilizing role for IL-10.

Soluble CD44 and IL-10 may serve as potentially useful biomarkers for the identification of high risk patients with UA.

Further studies are recommended for evaluation of the plaque stabilizing effect of recombinant IL-10 therapy in patients with UA.