Document Detail

Persistent activation of nuclear factor kappa-B signaling pathway in patients with unstable angina and elevated levels of C-reactive protein evidence for a direct proinflammatory effect of azide and lipopolysaccharide-free C-reactive protein on human monocytes via nuclear factor kappa-B activation.
MedLine Citation:
PMID:  17222729     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Our study investigated: 1) the contribution of nuclear factor kappa-B (NF-kappaB) signaling pathway to the enhanced inflammatory response observed in unstable angina (UA) patients with elevated levels of C-reactive protein (CRP); and 2) whether CRP may have direct proinflammatory effects via NF-kappaB activation. BACKGROUND: Unstable angina patients with elevated CRP have enhanced inflammatory response and increased risk of persistent instability, myocardial infarction, and death. METHODS: We studied 28 patients with history of UA and persistently elevated CRP (>3 mg/l) followed for 24 months and free of symptoms for at least 6 months (group 1), 14 patients with history of UA and low CRP (group 2), and 24 patients with chronic stable angina and low CRP (group 3). Peripheral blood monocytes were analyzed for spontaneous NF-kappaB activation and interleukin (IL)-6 and tumor necrosis factor (TNF)-alpha production. To assess the direct proinflammatory effects of CRP, monocytes from 8 healthy subjects were stimulated in vitro with increasing doses of CRP (5 to 10 to 25 microg/ml), lipopolysaccharide (LPS) (1 to 10 ng/ml), or both. RESULTS: Spontaneous NF-kappaB activation in vivo was demonstrated in 82% of group 1 versus 14% of group 2 and 21% of group 3 patients (p < 0.001). Interleukin-6 and TNF-alpha production was significantly correlated with the NF-kappaB activation status (r = 0.55, p < 0.001 and r = 0.53, p = 0.006, respectively). Patients with NF-kappaB activation had recurrence of acute coronary events (60% vs. 28%; p = 0.017). C-reactive protein induced a significant but modest in vitro NF-kappaB activation in human monocytes (p = 0.002). Coincubation with LPS produced a greater-than-additive response (p < 0.01 vs. CRP and LPS alone). CONCLUSIONS: Nuclear factor kappa-B activation might represent a mechanism by which CRP amplifies and perpetuates the inflammatory component of acute coronary syndromes and influences the clinical outcome.
Giovanna Liuzzo; Matteo Santamaria; Luigi M Biasucci; Michela Narducci; Valeria Colafrancesco; Annalisa Porto; Salvatore Brugaletta; Michela Pinnelli; Vittoria Rizzello; Attilio Maseri; Filippo Crea
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Publication Detail:
Type:  In Vitro; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-12-29
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  49     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-15     Completed Date:  2007-02-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  185-94     Citation Subset:  AIM; IM    
Institute of Cardiology, Catholic University, Rome, Italy.
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MeSH Terms
Angina, Unstable / immunology*,  metabolism
Azides / pharmacology
C-Reactive Protein / metabolism*,  pharmacology
Enzyme-Linked Immunosorbent Assay
Inflammation Mediators / metabolism
Interleukin-6 / metabolism
Lipopolysaccharides / metabolism,  pharmacology
Microscopy, Confocal
Middle Aged
Monocytes / drug effects*,  immunology*
NF-kappa B / metabolism*
Reference Values
Sensitivity and Specificity
Signal Transduction / physiology
Tumor Necrosis Factor-alpha / metabolism
Reg. No./Substance:
0/Azides; 0/Inflammation Mediators; 0/Interleukin-6; 0/Lipopolysaccharides; 0/NF-kappa B; 0/Tumor Necrosis Factor-alpha; 9007-41-4/C-Reactive Protein
Comment In:
J Am Coll Cardiol. 2007 Jan 16;49(2):195-7   [PMID:  17222730 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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