Prevalence of telomerase in coronary artery atherosclerosis

Telomerase is an essential enzyme for maintaining the telomeres of chromoso mes and thereby enhancing the sustained replication of cells. Because ather osclerosis and restenosis are characterized by cellular proliferation, we d etermined whether telomerase enzyme activity was present in coronary artery tissue from 23 patients undergoing directional coronary atherectomy. Telom erase activity was determined from detergent lysates of the atherectomy tis sue using an enzyme-linked immunoadsorbent assay (ELISA);based modification of the Telomere Repeat Amplification Protocol. The presence of telomerase activity was correlated with the occurrence of coronary artery restenosis. Eight of the 23 samples (35%) were positive for telomerase, Seventeen of th e 23 patients had adequate clinical follow-up to judge restenosis status. O f these, 7 had restenosis and 5 of these 7 had detectable telomerase. Of th e 10 patients without restenosis, 8 were telomerase negative (p less than o r equal to 0.05). We have shown, for the first time, that telomerase is fou nd in 35% of atherosclerotic tissues. There was a strong trend toward an as sociation between telomerase presence and restenosis in patients for whom f ollow-up data were available. The presence of telomerase in atherosclerotic tissue may enable a robust, sustained cellular proliferation in response t o vascular injury that culminates in restenosis.