Abstract
ObjectivePentraxins like C-reactive protein are key components of the innate immune system. Recently, pentraxin-3 (PTX3) has been proposed to be a specific marker of vascular inflammation, yet its association with atherosclerosis is still unclear.Methods and ResultsPTX3 serum levels were measured in three independent studies of 132 young men (ARMY Study), 205 young women (ARFY Study) and 562 individuals 55 to 94 years old (Bruneck Study). In contrast to C-reactive protein, PTX3 showed little relationships with classic vascular risk factors and pro-inflammatory conditions. In the population based Bruneck Study, PTX3 level was independently associated with prevalent cardiovascular diseases (multivariable odds ratio [95%CI] 3.09 [1.65–5.79]; P<0.001). Moreover, PTX3 level correlated with the severity of carotid and femoral atherosclerosis and was highest in individuals with multiple vascular territories affected. In contrast, there was no association with elevated intima-media thickness, a precursor lesion of atherosclerosis, in any of the three populations investigated.ConclusionsLevel of PTX3 is independently associated with atherosclerosis and manifest cardiovascular disease but not early vessel pathology. Unlike C-reactive protein, PTX3 is not a component of the classic acute phase response (systemic inflammation) but appears to be more specific for vascular inflammation.
Highlights
It is well documented, that immunological and inflammatory processes play a fundamental role in atherogenesis.[1,2,3] Pentraxins are key components of the humoral arm of the innate immune system.[4]
Level of PTX3 is independently associated with atherosclerosis and manifest cardiovascular disease but not early vessel pathology
After adjustment for multiple testing, significant age- and sex-adjusted associations were found for neutrophil count and matrixmetalloproteinase 9 (MMP-9) level not for chronic infection and pro-inflammatory vascular risk conditions (Table 1)
Summary
That immunological and inflammatory processes play a fundamental role in atherogenesis.[1,2,3] Pentraxins are key components of the humoral arm of the innate immune system.[4]. A long pentraxin – pentraxin-3 (PTX3) – has moved into the focus of research. It is expressed in monocytes, macrophages, endothelical cells, dentritic cells, fibroblasts and epithelial cells [4] – all of which are present in the vascular wall and increased in atherosclerotic plaques – and a potential specific marker of inflammation and atherosclerotic changes of the vascular wall.[5,6,7] High PTX3 levels have been associated with unstable angina [8], adverse outcome after myocardial infarction [9] and heart failure [10]. It shows little correlations with standard vascular risk factors [11], is not produced in the liver but locally in atherosclerotic lesions themselves [12] and was reported to accumulate during atherosclerosis progression in a murine model [13] - making PTX3 a promising and more specific marker for vascular inflammation
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