Enhanced Rho-Kinase Activity in Circulating Neutrophils of Patients With Vasospastic Angina: A Possible Biomarker for Diagnosis and Disease Activity Assessment

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• 作者：Yoku  ; Kikuchi MD ; Satoshi  ; Yasuda MD ; PhD  ; ;   ; ^{syasuda@hsp.ncvc.go.jp} ; Kentaro  ; Aizawa MD ; Ryuji  ; Tsuburaya MD ; PhD ; Yoshitaka  ; Ito MD ; PhD ; Morihiko  ; Takeda MD ; PhD ; Masaharu  ; Nakayama MD ; PhD ; Kenta  ; Ito MD ; PhD ; Jun  ; Takahashi MD ; PhD ; Hiroaki  ; Shimokawa MD ; PhD
• 关键词：acetylcholine ; inflammation ; leukocytes ; vasospasm
• 刊名：Journal of the American College of Cardiology
• 出版年：2011
• 出版时间：13 September 2011
• 年：2011
• 卷：58
• 期：12
• 页码：1231-1237
• 全文大小：648 K

文摘

Objectives

The aim of this study was to examine whether Rho-kinase activity is systemically enhanced in patients with vasospastic angina (VSA) and, if so, whether a noninvasive diagnostic method could be developed to improve practice.

Background

The activated Rho-kinase pathway plays a central role in the molecular mechanism of coronary vasospasm in animal models and patients with VSA. Recently, it has been reported that Rho-kinase activity in circulating leukocytes is associated with various diseases.

Methods

Fifty-three consecutive patients with chest pain who underwent acetylcholine provocation testing for coronary spasm were examined. Patients were divided into 2 groups depending on their response to the test: VSA (n = 33) and non-VSA (n = 20) groups. Venous blood samples were collected to measure Rho-kinase activity in circulating neutrophils, determined by the extent of phosphorylation of myosin-binding subunit (MBS), a substrate of Rho-kinase.

Results

Rho-kinase activity was significantly higher in the VSA group than in the non-VSA group (phosphorylated MBS/total MBS ratio 1.33 ¡À 0.37 vs. 0.95 ¡À 0.22, p < 0.001). In the VSA group, no correlation was noted between Rho-kinase activity and high-sensitivity C-reactive protein, smoking, or accumulated number of coronary risk factors. After the 3-month medical treatment, Rho-kinase activity in the VSA group was significantly decreased to 1.08 ¡À 0.31 (p < 0.001). On receiver-operating characteristic curve analysis, a phosphorylated MBS ratio of 1.18 was identified as the best cutoff level to predict the diagnosis of VSA.

Conclusions

These results indicate that Rho-kinase activity in circulating neutrophils is enhanced in patients with VSA and may be a useful biomarker for diagnosis and disease activity assessment of the vasospastic disorder.