Inflammatory and antioxidant pattern unbalance in "clopidogrel-resistant" patients during acute coronary syndrome.
Inflammatory and antioxidant pattern unbalance in "clopidogrel-resistant" patients during acute coronary syndrome.
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DOI：
10.1155/2015/710123
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发表时间：
2015
影响因子：
4.6
通讯作者：
Parodi O
中科院分区：
文献类型：
--
作者：
Caruso R;Rocchiccioli S;Gori AM;Cecchettini A;Giusti B;Parodi G;Cozzi L;Marcucci R;Parolini M;Romagnuolo I;Citti L;Abbate R;Parodi O
背景在急性冠状动脉综合征（ACS）中，炎症和氧化还原反应与氯吡格雷治疗后残余血小板反应性（RPR）增加相关。我们研究了在对氯吡格雷反应不同的ACS患者中，氯吡格雷相互作用是否影响血小板功能以及调节炎症和氧化相关因子。材料与方法。在29例接受阿司匹林/氯吡格雷双重抗血小板治疗的ACS患者中测定血小板聚集。无应答者（NR）定义为ADP测定RPR ≥70%。测定了几个炎症和氧化还原参数，并测定了血小板蛋白质组。结果29例ACS患者中有8例（28%）对氯吡格雷无效。在24小时，NR中Th 2型细胞因子IL-4、IFNγ和MCP-1的水平高于应答者（R），而血液GSH（r-GSHbl）水平低于应答者（R）。蛋白质组学分析证明血小板粘附分子CD 226水平上调，抗氧化剂peroxiredoxin-4下调。在R患者中，促炎细胞因子IL-6减少，而抗炎细胞因子IL-1 Ra增加。结论.在接受氯吡格雷治疗的高RPR患者中，急性期观察到炎症因子、血小板粘附分子、循环和血小板抗氧化分子失衡。促炎环境在急性事件后的无应答者中持续很长时间，而抗氧化血液因子倾向于符合正常的反应性。
Background. In acute coronary syndrome (ACS), inflammation and redox response are associated with increased residual platelet reactivity (RPR) on clopidogrel therapy. We investigated whether clopidogrel interaction affects platelet function and modulates factors related to inflammation and oxidation in ACS patients differently responding to clopidogrel. Material and Methods. Platelet aggregation was measured in 29 ACS patients on dual (aspirin/clopidogrel) antiplatelet therapy. Nonresponders (NR) were defined as RPR ≥70% by ADP. Several inflammatory and redox parameters were assayed and platelet proteome was determined. Results. Eight (28%) out of 29 ACS patients resulted NR to clopidogrel. At 24 hours, the levels of Th2-type cytokines IL-4, IFNγ, and MCP-1 were higher in NR, while blood GSH (r-GSHbl) levels were lower in NR than responders (R). Proteomic analysis evidenced an upregulated level of platelet adhesion molecule, CD226, and a downregulation of the antioxidant peroxiredoxin-4. In R patients the proinflammatory cytokine IL-6 decreased, while the anti-inflammatory cytokine IL-1Ra increased. Conclusions. In patients with high RPR on clopidogrel therapy, an unbalance of inflammatory factors, platelet adhesion molecules, and circulatory and platelet antioxidant molecules was observed during the acute phase. Proinflammatory milieu persists in nonresponders for a long time after the acute event while antioxidant blood factors tend to conform to normal responsiveness.
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影响因子：
2.7
作者：
Braunwald, Eugene;Angiolillo, Dominick;Wiviott, Stephen
通讯作者：
Wiviott, Stephen
影响因子：
4.4
作者：
Lopez-Farre, Antonio J.;Mateos-Caceres, Petra J.;Macaya, Carlos
通讯作者：
Macaya, Carlos
DOI：
10.1111/j.1749-6632.2009.04813.x
发表时间：
2009-01-01
期刊：
CONTEMPORARY CHALLENGES IN AUTOIMMUNITY
影响因子：
--
作者：
Lacotte, Stephanie;Brun, Susana;Dumortier, Helene
通讯作者：
Dumortier, Helene
影响因子：
4.8
作者：
Campolo, Jonica;Penco, Silvana;Parodi, Oberdan
通讯作者：
Parodi, Oberdan
影响因子：
4.8
作者：
Kojima, H;Kanada, H;Shibuya, A
通讯作者：
Shibuya, A