Role of cytokines in the pathogenesis of restenosis after percutaneous transluminal coronary angioplasty

Background Inflammatory cytokines play an important role in mediating infla mmatory/proliferative responses including atherosclerosis, However, their r ole in the pathogenesis of restenosis after percutaneous transluminal coron ary angioplasty (PTCA) remains to be clarified. Objective To determine plasma levels of inflammatory cytokines as well as c ytokine-generation capacities of monocytes before PTCA and after the follow -up period. Methods Plasma levels of cytokines in 34 consecutive patients before and 3- 6 months after PTCA were measured by enzyme-linked immunosorbent assay. We measured the plasma levels of macrophage-colony-stimulating factor (MCSF) a nd transforming growth factor-beta, Cytokine-generation capacities of monoc ytes were also measured by a whole-blood induction method with lipopolysacc haride, The levels of cytokines measured for assessment of the capacities i ncluded those of interleukin-1 alpha, interleukin-1 beta, interleukin-6, gr anulocyte-colony-stimulating factor, tumor necrosis factor-alpha and interf eron-gamma. Results Plasma levels of MCSF in patients without restenosis (n = 20) decre ased significantly (from 1460 +/- 138 mug/ml before PTCA to 1039 +/- 125 mu g/ml after the follow-up period, P < 0.01), whereas those in patients with restenosis (n = 14) increased significantly (from 1107 +/- 105 <mu>g/ml bef ore PTCA to 1039 +/- 125 mug/ml after the follow-up period, P < 0.05). We n oted a positive correlation between the increase in plasma levels of MCSF a nd the extent of loss of lumen by restenosis, Cytokine-generation capacitie s of monocytes for interleukin-1<alpha> and interleukin-1 beta of patients with restenosis significantly increased but those of patients without reste nosis did not. Furthermore, plasma levels of C-reactive protein decreased s ignificantly only in patients without restenosis after the follow-up period , Conclusions These results suggest that inflammatory changes mediated by cyt okines may be involved in the pathogenesis of restenosis after PTCA, Coron Artery Dis 12:107-113 (C) 2001 Lippincott Williams & Wilkins.