Effect of influenza vaccine on markers of inflammation and lipid profile

Despite wide use of the influenza vaccine, relatively little is known about its effect on the measurement of inflammatory markers. Because inflammatory markers such as C-reactive protein (CRP) are increasingly being used in conjunction with lipids for the clinical assessment of cardiovascular disease and in epidemiologic studies, we evaluated the effect of influenza vaccination on markers of inflammation and plasma lipid concentrations. We drew blood from 22 healthy individuals 1 to 6 hours before they were given an influenza vaccination and 1, 3, and 7 days after the vaccination. Plasma CRP, interleukin (IL)-6, monocyte chemotactic protein 1, tumor necrosis factor alpha, IL-2 soluble receptor alpha, and serum amyloid A were measured, and differences in mean concentrations of absolute and normalized values on days 1, 3, and 7 were compared with mean baseline values. There was a significant increase in mean IL-6 (P < .01 absolute values, P < .001 normalized values) on day 1 after receiving the influenza vaccine. The mean increases in normalized high sensitivity CRP values were significant on day 1 (P < .01) and day 3 (P = .05), whereas the mean increase in normalized serum amyloid A was significant only on day 1 (P < .05). No significant changes were seen in mean concentrations of IL-2 soluble receptor alpha, monocyte chemotactic protein-1, or tumor necrosis factor-alpha. Of the lipids, significant decreases in mean concentrations of normalized triglyceride values were seen on days 1 (P < .05), 3 (P < .001), and 7 (P < .05) after vaccination. Our findings show that the influenza vaccination causes transient changes in select markers of inflammation and lipids. Consequently, clinical and epidemiologic interpretation of the biomarkers affected should take into account the possible effects of influenza vaccination.     

冠心病患者血清脂蛋白(a)水平临床分析

目的:评价血清脂蛋白(a)[Lp(a)]在冠心病(CHD)诊疗中的地位和作用。方法:取250例患者血清进行测定Lp(a)和总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),其中正常组63例,冠心病组89例,高血压病组52例,其它类心脏病组46例。结果:①冠心病组血清Lp(a)较其他3组均显著升高(P<0.01),高血压组和其它类心脏病组与正常组Lp水平比较,无显著统计学差异(P>0.05);②冠心病单支病变组、2支病变组、2支以上病变组各组间血清Lp(a)水平比较差异均有统计学意义;③冠心病非急性心肌梗死患者与急性心肌梗死患者血清Lp(a)浓度无明显差异(P>0.05);④多因素逐步回归分析表明,Lp(a)与TG、TC、HDL-C之间无显著相关。结论:高Lp(a)水平是冠心病的独立危险因子,对于预测冠心病的发生有一定的价值,但对于预测冠心病急性心血管病事件的发生却未见明显的优势。     

Intense lipid peroxidation in premature clinical coronary atherosclerosis is associated with metabolic abnormalities

Increased oxidative stress is associated with rapid progression of atherosclerosis. In this study we sought to determine whether premature onset of clinical coronary atherosclerosis is associated with increased levels of lipid peroxidation. We measured plasma levels of malondialdehyde (MDA), using high-pressure liquid chromatography, in 42 male patients with early- (<56 years) or late-onset (>64 years) unstable angina and in 2 age-matched control groups (n=20). Plasma MDA levels were higher in the patients with unstable angina than in the control groups (1.57 +/- 0.07 vs 1.14 +/- 0.03 nmol/mL; P<.001). Patients with early-onset angina showed higher MDA levels than those in late-onset patients (1.75 +/- 0.11 vs 1.44 +/- 0.097 nmol/mL; P<.05), despite a similar prevalence of risk factors for atherothrombosis. The inflammatory component, measured with the use of a high-sensitivity enzyme-linked immunosorbent assay for C-reactive protein, and platelet activity, measured as prothrombin fragment 1+2, failed to predict MDA level. Fasting glucose (P<.05) was the best predictor of MDA level in patients with early-onset unstable angina; uric acid (P=.09) and body-mass index (P=.15) showed trends toward significant correlation with MDA level in the same group of patients. Metabolic abnormalities related to insulin resistance in patients with premature coronary atherosclerosis appear to be important mediators of major plasma oxidative damage.     

老年冠状动脉粥样硬化性心脏病亚临床期高密度脂蛋白的变化

目的分析老年冠状动脉粥样硬化性心脏病 (冠心病 )患者亚临床期高密度脂蛋白 (HDL)的变化 ,为冠心病的预防提供依据。方法随机选取冠心病者 (研究组 )和非冠心病者 (对照组 )各 30 0例 ,分析冠心病患者在确诊当年及前 4年的HDL变化 ,并与对照组比较。结果冠心病组确诊前 1年HDL(1 .39± 0 .34)mmol/L ,明显低于非冠心病组 (1 .50± 0 .52 )mmol/L(P <0 .0 1 ) ;冠心病组诊断当年及前 4年的HDL变化曲线显示 :在诊断前 1年HDL处于最低谷 ,而在诊断当年HDL明显升高。结论HDL与冠心病的发生密切相关。HDL在冠心病明确诊断前 1年最低 ,诊断的当年最高 ,且呈上升趋势 ,这充分说明干预血脂措施非常必要     

补肾活血方对高糖高脂诱导损伤的小鼠脑微血管内皮细胞内质网应激和RAGE/LRP-1蛋白表达的影响

目的:在细胞水平探索补肾活血方对高糖高脂诱导的小鼠脑微血管内皮细胞(BEND3细胞)损伤的改善作用,并探究补肾活血方对高糖高脂导致的内质网应激和转运Aβ相关受体蛋白的作用。方法:采用高糖高脂(25mmol/L葡萄糖,200μmol/L棕榈酸)刺激BEND3细胞,用CCK-8法筛选合适的补肾方(BS)、活血方(HX)、补肾活血方(BSHX)的最佳用药浓度;应用免疫蛋白印迹法检测BS、HX、BSHX最佳用药浓度对葡萄糖调节蛋白78(GRP78)、磷酸化真核起始因子2α(p-eIF2α)、活性转录因子4(ATF4)、核因子κB(NF-κB)抗体以及脑内与转运β淀粉样蛋白相关的晚期糖基化终产物受体(RAGE)和低密度脂蛋白受体相关蛋白-1(LRP-1)的表达情况。结果:CCK-8检测细胞活力,最终选定补肾方100mg/L、活血方20mg/L和补肾活血方120mg/L;与正常对照组比较,高糖高脂刺激BEND3细胞后,GRP78、p-eIF2α、ATF4、NF-κB、RAGE表达显著增加(P<0.01),LRP-1表达下降(P<0.01);药物干预后,GRP78、p-eIF2α、ATF4、NF-κB、RAGE蛋白下调,BSHX组LRP-1表达显著上调(P<0.05,P<0.01);且以BSHX组最为明显。结论:补肾方、活血方、补肾活血方对高糖高脂诱导的BEND3细胞损伤均有改善作用,但以补肾活血方疗效最为突出,且对高糖高脂导致的内质网应激和转运β淀粉样蛋白受体的蛋白表达具有调节作用。     

Emerging biologic therapies for hypercholesterolaemia

Introduction: LDL-cholesterol (LDL-C) is one of the most well-established risk factors for CV disease. Indeed, therapies that decrease LDL-C are proven to effectively reduce the risk of atherosclerotic CV disease. Monoclonal antibodies (mAbs) that target proprotein convertase subtilisin/kexin type 9 (PCSK9) have recently gained traction as a promising therapeutic strategy.

Areas covered: In this review, the authors discuss the effectiveness of mAbs against PCSK9 in lowering low-density lipoprotein cholesterol (LDL-C) and other atherogenic lipid fractions. The discontinuation in the development of bococizumab due to efficacy and safety concerns, and the initial promising data about inclisiran, a long-acting small inhibiting RNA molecule against PCSK9 synthesis, is also discussed.

Expert opinion: Initial data about cardiovascular (CV) outcomes in large scale, long-term studies suggest a possible further therapeutic pathway for LDL-C reduction, and currently support the notion that further LDL-C reduction, obtained with PCSK9 inhibition on top of best available therapy, provides increased CV protection in subjects at very high CV risk. The development and marketing of mAbs against PCSK9 could help to redefine current therapeutic strategies aimed at reducing cardiovascular (CV) morbidity and risk, through the reduction of LDL-C concentrations. The cost-effectiveness of these emerging drugs is yet to be established.     

严重烧伤对红细胞膜胆固醇含量及红细胞滤过指数的影响

目的　研究严重烧伤患者早期红细胞膜胆固醇与红细胞滤过指数的变化及意义。方法　利用核孔滤膜法测量红细胞滤过指数 ,使用化学修饰电极测量红细胞膜胆固醇。结果　严重烧伤患者早期与对照组比较红细胞滤过指数显著下降 ,而红细胞膜胆固醇则显著升高 (P <0 0 1) ,且二者呈高度负相关 (r =- 0 80 1)。结论　严重烧伤患者早期红细胞膜胆固醇含量的升高 ,有可能是引起红细胞滤过指数下降的一个重要原因。     

Visit-to-visit variability of lipid measurements as predictors of cardiovascular events

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