Analytical Performance/Clinical Utility Of Laboratory Te

研究了用于测量脂蛋白的各种商业方法（两种不同的elisa和一种免疫比浊法）的分析性能(a)，我们观察到它们的标准化在分析和临床上的重要差异。此外，我们发现三种方法中至少有两种存在载脂蛋白(a)亚型依赖的证据，这进一步质疑了它们的临床实用性。在一项合作研究中，我们研究了频繁献血对健康成人献血者动脉粥样硬化发展的可能影响。尽管频繁献血减少了体内铁储量，但没有证据表明颈动脉内膜厚度和多种实验室炎症标志物可以降低动脉粥样硬化的风险。在另一项合作临床研究中，我们观察到HMG-CoA还原酶抑制剂药物（“他汀类药物”）与雌激素联合使用可减轻绝经后妇女雌激素替代治疗期间c反应蛋白的增加。这一点很重要，因为c反应蛋白水平升高可能会导致炎症和血栓形成，从而损害雌激素降低心血管风险的任何益处。在第三项合作临床研究中，我们评估了激素替代疗法对健康绝经后妇女颈动脉顺应性的影响。我们发现，通过磁共振成像（MRI）和血压测量，3个月的激素替代疗法显著改善了颈动脉顺应性。这种效果与血清脂质水平和炎症标志物（包括c反应蛋白）的变化无关。在第四项合作临床研究中，我们研究了血管紧张素II型1 （AT1）受体在动脉粥样硬化中调节细胞粘附分子的作用。我们发现氯沙坦（一种AT1受体拮抗剂）诱导的AT1受体拮抗剂选择性地调节白细胞上l -选择素的表达，而不影响其他白细胞和血清粘附分子和c反应蛋白。l -选择素是一种白细胞粘附分子，在白细胞活化后迅速脱落，因此在冠状动脉疾病中经常减少。在另一项合作临床研究中，我们继续研究各种热休克蛋白抗体与冠状动脉疾病之间的关系。目前正在评价这项研究的结果。

Studying the analytical performance of various commercial methods (two different ELISAs and an immunoturbidimetric method) for the measurement of lipoprotein(a), we observed analytically and clinically important differences in their standardization. In addition, we found evidence for apolipoprotein(a) isoform-dependence in at least two of three methods, that further questions their clinical utility. In a collaborative study, we studied the possible effect of frequent blood donations on the development of atherosclerosis in healthy adult blood donors. Despite reductions in body iron stores by frequent blood donation, there was no evidence for a reduced risk of atherosclerosis as assessed by carotid artery intimal thickness and a variety of multiple laboratory markers of inflammation. In another collaborative clinical study, we observed that combination of an HMG-CoA reductase inhibitor drug ("statin") with estrogen attenuates the increase in C-reactive protein during estrogen replacement therapy in postmenopausal women. This is of importance because elevated C-reactive protein levels may have inflammatory and thrombotic consequences that compromise any benefit to cardiovascular risk reduction by estrogens. In a third collaborative clinical study, we assessed the effect of hormone replacement therapy on carotid artery compliance in healthy postmenopausal women. We found that a 3-month hormone replacement therapy significantly improved the carotid artery compliance, as determined by magnetic resonance imaging (MRI) and blood pressure measurements. This effect was independent of changes in serum levels of lipids and markers of inflammation, including C-reactive protein. In a fourth collaborative clinical study, we studied the role of angiotensin II type 1 (AT1) receptor in the regulation of cellular adhesion molecules in atherosclerosis. We found that AT1 receptor antagonism induced by the administration of losartan (an AT1 receptor antagonist) selectively modulated the expression of L-selectin on leukocytes, while did not affect other leukocyte and serum adhesion molecules and C-reactive protein. L-selectin is a leukocyte adhesion molecule that is rapidly shed after leukocyte activation so it is often decreased in coronary artery disease. In still another collaborative clinical study, we continued studying the relationship between antibodies to various heat-shock proteins and coronary artery disease. Results of this study are being evaluated.