Abstract
ObjectivesYKL-40 has been demonstrated to be related to atherosclerosis, but its role in predicting plaque status and the outcome of carotid atherosclerosis (CAS) caused by CagA-positive helicobacter pylori remains unclear. This study was aimed to investigate the role of YKL-40 in predicting the outcome of carotid atherosclerosis with CagA-positive Helicobacter pylori infection.MethodsThe serum concentrations of YKL-40, C-reaction protein in 310 patients undergoing color Duplex assessment of carotid atherosclerosis were recorded and divided into 3 groups according to the infectious statuses of helicobacter pylori. We also examined serum YKL-40, C-reaction protein and the plaque morphology in animal model of carotid atherosclerosis with different types of helicobacter pylori infection.ResultsOverexpression of YKL-40 was only found in carotid atherosclerosis group with CagA-positive helicobacter pylori infection; C-reaction protein failed to distinguish different infectious statuses of helicobacter pylori infection. In patients with CagA-positive helicobacter pylori infection, elevated YKL-40 expression was accompanied by more severe clinical symptoms. We also confirmed similar findings in rabbit model of carotid atherosclerosis with CagA-positive helicobacter pylori infection. We found that in 7 rabbits treated with anti-helicobacter pylori therapy, the serum YKL-40 level decreased and the plaque became more stable.ConclusionOur findings suggested that increased serum YKL-40 level indicates plaque instability and more severe clinical symptoms of carotid atherosclerosis with CagA-positive helicobacter pylori infection. Compared with C-reaction protein, YKL-40 seems to be a more specific predictor of plaque status and outcome of carotid atherosclerosis with CagA-positive helicobacter pylori infection.
Highlights
Atherosclerotic stroke is an increasingly critical problem worldwide
A recent study has demonstrated that CagA-positive Helicobacter pylori (CagA+ HP) infection is correlated with atherosclerotic stroke [1], and a further study has confirmed the relationship between CagA+ HP infection and the plaque instability [2]
Patients and Participants From January 2008 to October 2008, all patients that were referred to Changhai Hospital for color Duplex assessment of carotid atherosclerosis were screened for enrollment in this study
Summary
Atherosclerotic stroke is an increasingly critical problem worldwide. A recent study has demonstrated that CagA-positive Helicobacter pylori (CagA+ HP) infection is correlated with atherosclerotic stroke [1], and a further study has confirmed the relationship between CagA+ HP infection and the plaque instability [2]. Considering the high frequency of cerebral symptoms and hospitalization and poor prognosis of atherosclerotic stroke, patients with carotid atherosclerosis need to be followed up closely, especially those with CagA+ HP infection. A novel biomarker is urgently needed to predict unstable carotid plaque and future atherosclerotic stroke risk. Recent studies have showed that serum YKL-40 level is increased in patients with stable coronary artery disease [7,8,9], and is associated with atherosclerotic progression [10]
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