Document Type : Short Communication

Authors

1 Professor, Cellular and Molecular Research Center AND Department of Biochemistry, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

2 Assistant Professor, Cellular and Molecular Research Center AND Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran

3 Department of Biochemistry, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

4 Professor, Department of Biochemistry, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

5 Professor, Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran

6 Associate Professor, Department of Cardiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

7 Associate Professor, Department of Physiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

Abstract

BACKGROUND: Coronary slow flow (CSF), an angiographic phenomenon that is characterized by a delayed coronary blood flow in the absence of obstructive coronary artery stenosis, is known as a disorder of the coronary microcirculation. Inflammation has an important role in the vascular hemostasis and endothelial dysfunction especially regarding monocyte adhesion and infiltration. Pro-inflammatory cytokines released by inflammatory cells result in endothelial cell dysfunction and cardiovascular diseases. It has been demonstrated that tumor necrosis factor-alpha (TNF-α) mainly influences the vascular homeostasis and endothelial dysfunction. In the present enquiry the transcriptional activity of TNF-α gene in peripheral blood mononuclear cells (PBMCs) of patients with CSF was compared with healthy controls in order to further survey the role of TNF-α in pathophysiology of CSF. METHODS: The study was carried out on 30 patients with CSF and 30 matched healthy controls. To analysis gene expression of TNF-α, total mRNA was isolated from PBMCs. The quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR) was used to compare the transcriptional activity of TNF-α gene between patients with CSF and controls. RESULTS: The mean ± standard error of mean of fold in CSF patients and controls were 0.20 ± 0.04 and 1.38 ± 0.27, respectively. The mRNA mean expressions of TNF-α (fold) were different in tested groups, which indicated a significant decrease in TNF-α in patients with CSF group (P = 0.0001). CONCLUSION: Expression of TNF-α was decreased in patients with CSF. Changes in TNF-α expression suggest a potential role for altered immune function in the pathophysiology of CSF. 

Keywords

  1. Fineschi M, Gori T. Coronary slow-flow phenomenon or syndrome Y: A microvascular angina awaiting recognition. J Am Coll Cardiol 2010; 56(3): 239-40.
  2. Wang X, Nie SP. The coronary slow flow phenomenon: Characteristics, mechanisms and implications. Cardiovasc Diagn Ther 2011; 1(1): 37-43.
  3. Chaudhry MA, Smith M, Hanna EB, Lazzara R. Diverse spectrum of presentation of coronary slow flow phenomenon: A concise review of the literature. Cardiol Res Pract 2012; 2012: 383181.
  4. Hawkins BM, Stavrakis S, Rousan TA, Abu-Fadel M, Schechter E. Coronary slow flow-prevalence and clinical correlations. Circ J 2012; 76(4): 936-42.
  5. Sanati H, Kiani R, Shakerian F, Firouzi A, Zahedmehr A, Peighambari M, et al. Coronary slow flow phenomenon clinical findings and predictors. Res Cardiovasc Med 2016; 5(1): e30296.
  6. Beltrame JF, Limaye SB, Wuttke RD, Horowitz JD. Coronary hemodynamic and metabolic studies of the coronary slow flow phenomenon. Am Heart J 2003; 146(1): 84-90.
  7. Selcuk H, Selcuk MT, Temizhan A, Maden O, Saydam GS, Ulupinar H, et al. Decreased plasma concentrations of adiponectin in patients with slow coronary flow. Heart Vessels 2009; 24(1): 1-7.
  8. Yildiz A, Gur M, Yilmaz R, Demirbag R, Polat M, Selek S, et al. Association of paraoxonase activity and coronary blood flow. Atherosclerosis 2008; 197(1): 257-63.
  9. Cin VG, Pekdemir H, Camsar A, Cicek D, Akkus MN, Parmaksyz T, et al. Diffuse intimal thickening of coronary arteries in slow coronary flow. Jpn Heart J 2003; 44(6): 907-19.
  10. Li JJ, Qin XW, Li ZC, Zeng HS, Gao Z, Xu B, et al. Increased plasma C-reactive protein and interleukin-6 concentrations in patients with slow coronary flow. Clin Chim Acta 2007; 385(1-2): 43-7.
  11. Ramaswamy SD, Vigmostad SC, Wahle A, Lai YG, Olszewski ME, Braddy KC, et al. Fluid dynamic analysis in a human left anterior descending coronary artery with arterial motion. Ann Biomed Eng 2004; 32(12): 1628-41.
  12. Gazi E, Temiz A, Altun B, Barutcu A, Silan F, Colkesen Y, et al. Endothelial function and germ-line ACE I/D, eNOS and PAI-1 gene profiles in patients with coronary slow flow in the Canakkale population: Multiple thrombophilic gene profiles in coronary slow flow. Cardiovasc J Afr 2014; 25(1): 9-14.
  13. Teupser D, Mueller MA, Koglin J, Wilfert W, Ernst J, von SW, et al. CD36 mRNA expression is increased in CD14+ monocytes of patients with coronary heart disease. Clin Exp Pharmacol Physiol 2008; 35(5-6): 552-6.
  14. Khojasteh-Fard M, Abolhalaj M, Amiri P, Zaki M, Taheri Z, Qorbani M, et al. IL-23 gene expression in PBMCs of patients with coronary artery disease. Dis Markers 2012; 33(6): 289-93.
  15. Faramarz-Gaznagh S, Rasmi Y, Khadem-Ansari MH, Seyed-Mohammadzad MH, Bagheri M, Nemati M, et al. Transcriptional activity of gene encoding subunits r1 and r2 of interferon gamma receptor in peripheral blood mononuclear cells in patients with slow coronary flow. J Med Biochem 2016; 35(2): 144-9.
  16. Turhan H, Saydam GS, Erbay AR, Ayaz S, Yasar AS, Aksoy Y, et al. Increased plasma soluble adhesion molecules; ICAM-1, VCAM-1, and E-selectin levels in patients with slow coronary flow. Int J Cardiol 2006; 108(2): 224-30.
  17. Kopetz V, Kennedy J, Heresztyn T, Stafford I, Willoughby SR, Beltrame JF. Endothelial function, oxidative stress and inflammatory studies in chronic coronary slow flow phenomenon patients. Cardiology 2012; 121(3): 197-203.
  18. Beltrame JF, Turner SP, Horowitz JD. Persistence of the coronary slow flow phenomenon. Am J Cardiol 2001; 88(8): 938.
  19. Margetic S. Inflammation and haemostasis. Biochem Med (Zagreb) 2012; 22(1): 49-62.
  20. Tedgui A, Mallat Z. Cytokines in atherosclerosis: Pathogenic and regulatory pathways. Physiol Rev 2006; 86(2): 515-81.
  21. Belkaid Y. Regulatory T cells and infection: A dangerous necessity. Nat Rev Immunol 2007; 7(11): 875-88.
  22. Sprague AH, Khalil RA. Inflammatory cytokines in vascular dysfunction and vascular disease. Biochem Pharmacol 2009; 78(6): 539-52.
  23. Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000; 342(12): 836-43.
  24. Guzik TJ, West NE, Black E, McDonald D, Ratnatunga C, Pillai R, et al. Vascular superoxide production by NAD(P)H oxidase: Association with endothelial dysfunction and clinical risk factors. Circ Res 2000; 86(9): E85-E90.
  25. Guzik TJ, Mussa S, Gastaldi D, Sadowski J, Ratnatunga C, Pillai R, et al. Mechanisms of increased vascular superoxide production in human diabetes mellitus: Role of NAD(P)H oxidase and endothelial nitric oxide synthase. Circulation 2002; 105(14): 1656-62.
  26. Shibata Y, Kume N, Arai H, Hayashida K, Inui-Hayashida A, Minami M, et al. Mulberry leaf aqueous fractions inhibit TNF-alpha-induced nuclear factor kappaB (NF-kappaB) activation and lectin-like oxidized LDL receptor-1 (LOX-1) expression in vascular endothelial cells. Atherosclerosis 2007; 193(1): 20-7.
  27. De Palma C, Meacci E, Perrotta C, Bruni P, Clementi E. Endothelial nitric oxide synthase activation by tumor necrosis factor alpha through neutral sphingomyelinase 2, sphingosine kinase 1, and sphingosine 1 phosphate receptors: A novel pathway relevant to the pathophysiology of endothelium. Arterioscler Thromb Vasc Biol 2006; 26(1): 99-105.
  28. True AL, Rahman A, Malik AB. Activation of NF-kappaB induced by H(2)O(2) and TNF-alpha and its effects on ICAM-1 expression in endothelial cells. Am J Physiol Lung Cell Mol Physiol 2000; 279(2): L302-L311.
  29. Gilmont RR, Dardano A, Engle JS, Adamson BS, Welsh MJ, Li T, et al. TNF-alpha potentiates oxidant and reperfusion-induced endothelial cell injury. J Surg Res 1996; 61(1): 175-82.
  30. Gao X, Xu X, Belmadani S, Park Y, Tang Z, Feldman AM, et al. TNF-alpha contributes to endothelial dysfunction by upregulating arginase in ischemia/reperfusion injury. Arterioscler Thromb Vasc Biol 2007; 27(6): 1269-75.
  31. Dorge H, Schulz R, Belosjorow S, Post H, van de Sand A, Konietzka I, et al. Coronary microembolization: The role of TNF-alpha in contractile dysfunction. J Mol Cell Cardiol 2002; 34(1): 51-62.
  32. Roberts R, Stewart AF. The genetics of coronary artery disease. Curr Opin Cardiol 2012; 27(3): 221-7.
  33. Steenman M, Lamirault G, Le Meur N, Leger JJ. Gene expression profiling in human cardiovascular disease. Clin Chem Lab Med 2005; 43(7): 696-701.
  34. Bruunsgaard H, Skinhoj P, Pedersen AN, Schroll M, Pedersen BK. Ageing, tumour necrosis factor-alpha (TNF-alpha) and atherosclerosis. Clin Exp Immunol 2000; 121(2): 255-60.
  35. Enayati S, Seifirad S, Amiri P, Abolhalaj M, Mohammad-Amoli M. Interleukin-1 beta, interferon-gamma, and tumor necrosis factor-alpha gene expression in peripheral blood mononuclear cells of patients with coronary artery disease. ARYA Atheroscler 2015; 11(5): 267-74.
  36. Torre-Amione G, Kapadia S, Benedict C, Oral H, Young JB, Mann DL. Proinflammatory cytokine levels in patients with depressed left ventricular ejection fraction: A report from the Studies of Left Ventricular Dysfunction (SOLVD). J Am Coll Cardiol 1996; 27(5): 1201-6.
  37. Horio T. Pathophysiological role of cytokines in heart failure. Nihon Rinsho 2006; 64(5): 843-7.
  38. Baena A, Leung JY, Sullivan AD, Landires I, Vasquez-Luna N, Quinones-Berrocal J, et al. TNF-alpha promoter single nucleotide polymorphisms are markers of human ancestry. Genes Immun 2002; 3(8): 482-7.
  39. Livak KJ, Schmittgen TD. Analysis of relative gene expression data using real-time quantitative PCR and the 2(-Delta Delta C(T)) Method. Methods 2001; 25(4): 402-8.
  40. Zhang H, Park Y, Wu J, Chen X, Lee S, Yang J, et al. Role of TNF-alpha in vascular dysfunction. Clin Sci (Lond ) 2009; 116(3): 219-30.
  41. Singh S, Kothari SS, Bahl VK. Coronary slow flow phenomenon: An angiographic curiosity. Indian Heart J 2004; 56(6): 613-7.
  42. Kleinbongard P, Heusch G, Schulz R. TNFalpha in atherosclerosis, myocardial ischemia/reperfusion and heart failure. Pharmacol Ther 2010; 127(3): 295-314.
  43. Aude YW, Garza L. How to prevent unnecessary coronary interventions: Identifying lesions responsible for ischemia in the cath lab. Curr Opin Cardiol 2003; 18(5): 394-9.
  44. Drexler H, Zeiher AM, Meinzer K, Just H. Correction of endothelial dysfunction in coronary microcirculation of hypercholesterolaemic patients by L-arginine. Lancet 1991; 338(8782-8783): 1546-50.
  45. McFadden EP, Clarke JG, Davies GJ, Kaski JC, Haider AW, Maseri A. Effect of intracoronary serotonin on coronary vessels in patients with stable angina and patients with variant angina. N Engl J Med 1991; 324(10): 648-54.
  46. Beltrame JF, Turner SP, Leslie SL, Solomon P, Freedman SB, Horowitz JD. The angiographic and clinical benefits of mibefradil in the coronary slow flow phenomenon. J Am Coll Cardiol 2004; 44(1): 57-62.