Vaskulárna medicína 2/2011

Plasma levels of proinflammatory kinines in abdominal aortic aneurysm

Objective: aetiopathogenesis of abdominal aortic aneurysm (AAA) is a complex process where inflammation plays a very important role. The aim of our study was to find out whether plasmatic levels of proinflammatory cytokines - tumor necrosis factor α (TNF a), interleukines 2, 6 and 8 (IL 2, 6 and 8) correlate with the development of AAA. Method: in a prospective non-randomized study 367 patients suffering from AAA were examined. Sixty-nine patients suffered from symptomatic AAA (N=78), 289 patients from asymptomatic AAA. Seventy two patiens had AAA diameter > 50 mm, 211 patients between 50 - 80 mm and 84 patients > 80 mm. The average age of the patients was 73.4 ± 7.2 years (56 - 86 years). Males: females ratio was 4:1. A control group was formed of 30 healthy volunteers of approximately the same age group and representative of gender without clinically manifest symptoms of artery disease. Plasma levels of cytokines were evaluated in the venous blood by enzymoimmunoanalysis. Results: Plasma levels of inflammatory cytokines were statistically significantly higher in the patients with AAA in comparison with healthy individuals. Plasma levels of IL 8 decreased significantly with the diameter of AAA (p<0.05). The levels of TNF alfa were significantly low in the patients with the symptomatic AAA (p<0.05). Conclusion: The study proved the importance of monitoring plasma levels of proinflammatory cytokines in the patients with AAA. Plasma levels of some cytokines e.g. IL 8 and also TNF alfa are highest in small, developing AAA. It would have an important significance on the targeted medicamentous treatment aimed at the blocking effect of these factors in the process of the inflammation in the wall of AAA. Low plasma levels of TNF a could give the evidence of an imminent rupture of AAA and thus support its early indication to open or endovascular treatment.

Keywords: abdominal aortic aneurysm, inflammatory cytokines