Bondareva O. O., Fedorov S. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Abstract. Introduction. The International Diabetes Federation (IDF) estimates that worldwide, 415 million people have diabetes, 91% of whom have type 2 diabetes mellitus (T2DM). The prevalence of T2DM has been steadily increasing over time. People with diabetes comprise 8.8% of the world’s population, and IDF predicts that the number of cases of diabetes will rise to 642 million by 2040. Cardiovascular disease (CVD) is a major cause of death and disability among people with diabetes. Globally, overall CVD affects approximately 32.2% of all persons with T2DM. CVD is a major cause of mortality among people with T2DM, accounting for approximately half of all deaths over the study period. Patients with diabetes are more likely to experience an acute myocardial infarction, heart failure, or death from cardiovascular causes than patients without diabetes. Macrophages derived from monocytes play an important role in atherosclerosis progression. Subpopulations of circulating classical, intermediate, and nonclassical monocytes possess distinct functions and phenotypes, and participate in the pathogenesis of disease. The aim of this study was investigation of monocyte/macrophage activity in patients with acute coronary syndrome (ACS) and DM by evaluation of their spontaneous production of some cytokines. Material and methods. We observed of 53 patients with ACS: 29 patients with concomitant 2 type DM and 24 patients without DM. 15 practically healthy persons were included into control group. The diagnosis of ACS was verified by laboratory and instrumental methods according to European Society of Cardiology guidelines (2017, 2020) The diagnosis of DM was verified by laboratory and instrumental methods according to American Diabetes Association guidelines (2020). Monocyte from blood were extracted by H. Recalde method. Spontaneous secretion of interleukine-1β (IL-1β), tumor necrosis factor (TNF-α) and IL-10 by monocytes was detected by ELISE method. The study was performed in accordance with the Good Clinical Practice Guideline and Helsinki Declaration. The p value of <0.05 was considered statistically significant. Analyses were performed with Statistica system software, version 12.0.Results. The average age of observed patients with ACS was: (67.5±11.7) years; 31 persons (58.5%) among them were males. Acute MI with ST elevation (STEMI) was verified in 43 (81.1%) persons. No significant difference between clinical and demography parameters was observed in both groups with ACS. The spontaneous production by monocytes of pro-inflammatory cytokines (ІL-1β and TNF-α) was higher in patients with ACS and co-existing DM. The excretion of IL-1β was higher for 1.5 times versus patient with ACS without DM (p<0.01) and for 3.16 times compare with control group (p<0.001). The spontaneous production by monocytes of TNF-α in patients with ACS and DM was higher for 2.44 times, compare with control (p<0.001), and for 1.4 times, compare with ACS patients without DM (p<0.001). The decline of IL-10 excretion was observed in both groups of patients with ACS, compare with control group. Conclusion. The monocytes of patients with ACS have pro-activation status, which characterized of high spontaneous production of pro-inflammatory cytokines IL-1β and TNF-α and down-secretion of anti-inflammatory IL-10.

acute coronary syndrome, diabetes mellitus, inflammation, cytokines, monocytes

1. Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol. 2018;17:83 DOI: https://doi.org/10.1186/s12933-018-0728-6.
2. Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Angelantonio D, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. emerging risk factors collaboration. Lancet. 2010;375:2215- 2222.
3. Alfaddagh A, Khraishah H, Kassab M, McMillan Z, Albaghdadi M. Cardiovascular Outcomes Among Patients With Acute Coronary Syndromes and Diabetes in India: Results From ACS QUIK Trial. Circulation. 2021;144:A14544.
4. Justo-Junior AS, Villarejos LM, Lima XTV, Nadruz W, Sposito AC, Mamoni R, et al. Monocytes of patients with unstable angina express high levels of chemokine and pattern-recognition receptors. Cytokine. 2019;113:61-67 DOI: doi.org/10.1016/j.cyto.2018.06.008.
5. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018 Jan 7;39(2):119-177.
6. Collet JP, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhat DL, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021 Apr 7;42(14):1289-1367.
7. ADA. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes – 2021. Diabetes Care. 2021;44(1):S15-S33.
8. Recalde HR. A simple method of obtaining monocytes in suspension. J. Immunol. Meth. 1984;69:71-77.
9. Szekely Y, Arbel Y A Review of Interleukin-1 in Heart Disease: Where Do We Stand Today? Cardiol Ther. 2018;7:25-44. DOI: https://doi. org/10. 1007/s40119-018-0104-3.
10. Aukrust P, Sandberg WJ, Otterdal K, Vinge LE, Gullestad L, Yndestad A, et al. Tumor necrosis factor superfamily molecules in acute coronary syndromes, Annals of Medicine. 2011;43:90-103 DOI: 10.3109/07853890. 2010.523711.
11. Pinderski Oslund LJ, Hedrick CC, Olvera T, Hagenbaugh A, Territo M, Berliner JA, et al. Interleukin-10 blocks atherosclerotic events in vitro and in vivo. Arterioscler Thromb Vasc Biol. 1999;19(12):2847-53. DOI: 10.1161/01.atv.19.12.2847.

«Bulletin of problems biology and medicine» Issue 4 (162), 2021 year, 99-102 pages, index UDK 616.12-008.1+616.092-18+616-092.4

10.29254/2077-4214-2021-4-162-99-102