THE MARKERS OF MONOCYTES ACTIVATION IN PATIENTS WITH ACUTE CORONARY SYNDROME AND 2 TYPE DIABETES MELLITUS

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

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«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