BEHAVIORAL AND IMMUNOLOGICAL FACTORS IN CORONARY DISEASE

冠心病的行为和免疫因素

• 批准号: 6745571
• 负责人: Willem Johan Kop
• 金额: $ 56.96万
• 依托单位: HENRY M. JACKSON FDN FOR THE ADV MIL/MED
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-07-06 至 2006-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6745571
• 关键词: acute phase protein; antigen antibody reaction; behavior; blood cell count; cardiovascular disorder epidemiology; cardiovascular stress test; cell adhesion molecules; clinical research; coronary disorder; cytokine; depression; echocardiography; fatigue; human subject; inflammation; interview; longitudinal human study; microorganism population study; pathologic process; patient oriented research; postoperative state; psychological tests; questionnaires; restenosis; stress

DESCRIPTION:(adapted from Investigator's abstract) Recent studies demonstrate that the immune system plays an important role in coronary artery disease (CAD). Research also shows that psychological factors such as major depressive disorder and acute mental stress are involved in the clinical progression of CAD. Depression is associated with higher levels of immune parameters that play a role in CAD (cytokines, markers of low grade inflammation, infectious pathogen burden, and adhesion molecules), and most of these measures also increase in response to acute physical and mental stress. The pathophysiological mechanisms linking depression and mental stress with adverse cardiovascular outcomes may therefore be mediated by immunological factors. The proposed research will examine clinical outcomes in patients who undergo percutaneous coronary revascularization, because a major problem remains the frequent (20 percent-40 percent) occurrence of coronary restenosis and new cardiac events in the 6 months after the intervention. These adverse outcomes have substantial impact on the costs of medical care and patients' quality of life. Since previous research has not examined the role of behaviorally-induced changes in immune parameters in the prediction of CAD progression, the following immunological measures will be examined: cytokines (IL-1B, IL-4, IL-6, IFNy, TNFa), acute phase proteins (CRP, fibrinogen), lymphocyte counts and differential, adhesion molecules (ICAM-1, LFA, L-selectin), and a composite measure of pathogen burden (CNV, H. pylori, C. pneumoniae). Using a longitudinal design, this project will determine the time course of changes in depression and changes in immune parameters. Moreover, the present study will determine the contribution of behavioral and immunological factors in the clinical progression of coronary disease following coronary angioplasty. These data may therefore improve the identification of patients at risk for recurrent cardiac events and restenosis after coronary angioplasty, and provide further understanding of the pathophysiological mechanisms involved in coronary disease progression.

描述：（根据研究者的摘要进行了改编）最近的研究表明 免疫系统在冠状动脉疾病中起重要作用 （CAD）。研究还表明，心理因素，例如重大抑郁症 疾病和急性精神压力参与 卡德。抑郁与较高水平的免疫参数有关 在CAD中的作用（细胞因子，低年级炎症的标记，感染性 病原体负担和粘附分子），其中大多数也 响应急性身体和精神压力。这 将抑郁和精神压力与不利的病理生理机制联系起来 因此，心血管结局可能是由免疫学因素介导的。这 拟议的研究将检查接受的患者的临床结果 经皮冠状动脉血运重建，因为一个主要问题仍然存在 冠状动脉再狭窄和新的经常发生（20％-40％） 干预后6个月的心脏事件。这些不利的结果 对医疗和患者的质量的成本有实质性影响 生活。由于以前的研究尚未检查行为引起的作用 在预测CAD进程中的免疫参数的变化， 将检查遵循免疫学措施：细胞因子（IL-1B，IL-4， IL-6，IFNY，TNFA），急性相蛋白（CRP，纤维蛋白原），淋巴细胞计数 和差异，粘附分子（ICAM-1，LFA，L-选择素）和复合材料 病原体负担的度量（CNV，H。Pylori，C。肺炎）。使用 纵向设计，该项目将确定变化的时间过程 抑郁症和免疫参数的变化。而且，本研究将 确定行为和免疫因素在 冠状动脉成形术后冠状动脉疾病的临床进展。这些 因此，数据可能会改善对经常性风险的患者的识别 冠状动脉成形术后心脏事件和再狭窄，并提供进一步的 了解冠状动脉疾病涉及的病理生理机制 进展。