Decreased serum TRAIL is associated with increased mortality in smokers with comorbid emphysema and coronary artery disease.
Decreased serum TRAIL is associated with increased mortality in smokers with comorbid emphysema and coronary artery disease.
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DOI：
10.1016/j.rmed.2018.10.018
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发表时间：
2018-12
影响因子：
4.3
通讯作者：
Chandra D
中科院分区：
文献类型：
--
作者：
Ajala O;Zhang Y;Gupta A;Bon J;Sciurba F;Chandra D
吸烟者对肺和心血管疾病非常敏感，这会降低他们的生存率。肿瘤坏死因子（TNF）相关凋亡诱导配体（TRAIL）是循环中的一种蛋白质，可抑制血管和肺部炎症。因此，我们假设循环中TRAIL水平的降低与吸烟者肺和心血管疾病的生存率低有关。采用免疫分析法测定474例吸烟者血清TRAIL水平。冠状动脉粥样硬化通过冠状动脉钙化积分沿着以及肺气肿、肺功能和存活率进行评估。474名吸烟者年龄为65.7 ± 6.3岁，52.2%为男性，烟草暴露量为55.3 ± 31.5包-年。随访3588.2人年，死亡83例。在基线时，较低的TRAIL水平与更多的冠状动脉钙相关（OR=1.2/SD，95%CI 1.1-1.5，p=0.02），有心肌梗死病史（OR=2.3/SD，95%CI 1.2-4.5，p=0.02），心绞痛（OR=1.6/SD，95%CI 1.1-2.6，p=0.03）和血管成形术（OR=1.8/SD，95%CI 1.0-3.1，p=0.04）。此外，较低的TRAIL水平与肺气肿严重程度相关，与人口统计学和烟草暴露无关（β=0.11 sq.根单位，95% CI 0.01-0.22，p=0.03）。此外，TRAIL水平最低的吸烟者共病肺气肿和冠状动脉钙化，而不是单独的条件。最后，较低的TRAIL水平与吸烟者的死亡率增加独立相关，特别是在合并肺气肿和冠状动脉钙化的患者中（HR=1.38，95%CI 1.01-1.90）。吸烟者合并肺气肿和冠状动脉疾病时，TRAIL水平降低，并与生存率降低相关。
Smokers are highly susceptible to lung and cardiovascular disease that can reduce their survival. Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) is a protein in the circulation that may suppress vascular and pulmonary inflammation. Therefore, we hypothesized that diminished circulating TRAIL levels would be associated with poor survival in smokers with lung and cardiovascular disease. Serum TRAIL level was measured by immunoassay in 474 smokers. Coronary atherosclerosis was assessed by coronary artery calcium scoring along with emphysema, lung function, and survival. The 474 smokers were 65.7 ± 6.3 years old and 52.2% male with 55.3 ± 31.5 pack-years of tobacco-exposure. 83 of them died during 3588.2 person-years of follow up. At baseline, lower TRAIL level was associated with more coronary artery calcium (OR=1.2 per SD, 95%CI 1.1–1.5, p=0.02), and with history of myocardial infarction (OR=2.3 per SD, 95%CI 1.2–4.5, p=0.02), angina (OR=1.6 per SD, 95%CI 1.1–2.6, p=0.03), and angioplasty (OR=1.8 per SD, 95%CI 1.0–3.1, p=0.04) in models adjusted for cardiovascular risk-factors, FEV1, and emphysema. Also, lower TRAIL level was associated with emphysema severity independent of demographics and tobacco exposure (β=0.11 sq. root units, 95% CI 0.01–0.22, p=0.03). Further, TRAIL level was lowest in smokers with comorbid emphysema and coronary artery calcification rather than either condition alone. Finally, lower TRAIL level was independently associated with increased mortality in smokers particularly in those with comorbid emphysema and coronary artery calcification (HR=1.38, 95% CI 1.01–1.90). TRAIL level is reduced in smokers with comorbid emphysema and coronary artery disease, and is associated with reduced survival.
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影响因子：
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作者：
Kim JY;Kim YM;Park JM;Han YM;Lee KC;Hahm KB;Hong S
通讯作者：
Hong S
影响因子：
9.6
作者：
Chandra, Divay;Stamm, Jason A.;Sciurba, Frank C.
通讯作者：
Sciurba, Frank C.
影响因子：
24
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通讯作者：
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影响因子：
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作者：
Liabeuf, Sophie;Barreto, Daniela V.;Massy, Ziad A.
通讯作者：
Massy, Ziad A.
影响因子：
0.9
作者：
Malyszko, J.;Przybylowski, P.;Mysliwiec, M.
通讯作者：
Mysliwiec, M.