Increased soluble programed cell death-ligand 1 is associated with acute coronary syndrome
Increased soluble programed cell death-ligand 1 is associated with acute coronary syndrome
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DOI：
10.1016/j.ijcard.2021.11.060
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发表时间：
2022-01-13
影响因子：
3.5
通讯作者：
Tsujita, Kenichi
中科院分区：
文献类型：
--
作者：
Fujisue, Koichiro;Yamamoto, Eiichiro;Tsujita, Kenichi
背景：程序性细胞死亡（PD）-1及其配体（PD-L1）作为免疫检查点在T细胞耐受中发挥重要作用。先前的研究报告称，可溶性PD-L1（sPD-L1）血清水平升高反映了心肌和血管炎症。然而，关于sPD-L1与急性冠状动脉综合征（ACS）之间的临床关系知之甚少。我们调查了sPD-L1与ACS的关系。方法：我们使用市售的酶联免疫吸附测定试剂盒前瞻性测量了2017年12月至2019年6月期间在熊本大学医院住院的冠状动脉疾病（CAD）和连续非CAD患者的血清sPD-L1水平。结果：共分析446例CAD患者（ACS，n = 124;慢性冠状动脉综合征（CCS，n = 322））和24例非CAD患者。ACS患者的sPD-L1水平显著高于非CAD和CCS患者{ACS，188.7（111.0-260.8）pg/mL，p < 0.001 vs.非CAD [83.5（70.8-130.4）pg/mL]; p = 0.009 vs. CCS [144.2（94.8-215.5）pg/mL]，分别}。单因素Logistic回归分析显示sPD-L1与ACS显著相关[比值比（OR）：1.459，95%可信区间（CI）：1.198-1.778，p < 0.001]。多因素Logistic回归分析显示，sPD-L1与ACS有显著独立相关性结论：本研究首次证实冠心病患者血清sPD-L1水平升高，并与ACS发生密切相关。
Background: Programmed cell death (PD)-1 and its ligand (PD-L1) plays crucial roles in T-cell tolerance as immune checkpoint. Previous studies reported that increased serum levels of soluble PD-L1 (sPD-L1) reflect myocardial and vascular inflammation. However, little is known about the clinical relationship between sPD-L1 and acute coronary syndrome (ACS). We investigated the relation of sPD-L1 and ACS.Methods: We prospectively measured serum levels of sPD-L1 using a commercially available enzyme-linked immunosorbent assay kit in patients with coronary artery disease (CAD) and continuous non-CAD admitted to Kumamoto University Hospital between December 2017 and June 2019. All malignant diseases, patients who underwent hemodialysis, active collagen diseases, and severe infectious diseases were excluded.Results: Totally, 446 CAD patients [ACS, n = 124; chronic coronary syndrome (CCS), n = 322] and 24 non-CAD patients were analyzed. The levels of sPD-L1 were significantly higher in patients with ACS than those both with non-CAD and CCS {ACS, 188.7 (111.0-260.8) pg/mL, p < 0.001 vs. non-CAD [83.5 (70.8-130.4) pg/mL]; and p = 0.009 vs. CCS [144.2 (94.8-215.5) pg/mL], respectively}. Univariate logistic regression analysis identified that sPD-L1 was significantly associated with ACS [odds ratio (OR): 1.459, 95% confidence interval (CI): 1.198-1.778, p < 0.001]. Multivariable logistic regression analysis with nine significant factors identified from the univariate analysis revealed that sPD-L1 was significantly and independently associated with ACS (OR: 1.561, 95% CI: 1.215-2.006, p < 0.001).Conclusions: This is the first clinical study to demonstrate the increased level of sPD-L1 in patients with CAD, and the significant association with ACS.