RESUMEN
BACKGROUND: Acute Kidney Injury (AKI), a common complication of acute coronary syndromes (ACS), is associated with higher mortality and longer hospital stays. The role of cytokines and other mediators is unknown in AKI induced by an ACS (ACS-AKI), leading to several unanswered questions. The worsening of renal function is usually seen as a dichotomous phenomenon instead of a dynamic change, so evaluating changes of the renal function in time may provide valuable information in the ACS-AKI setting. The aim of this study was to explore inflammatory factors associated to de novo kidney injury induced by de novo cardiac injury secondary to ACS. METHODS: One hundred four consecutive patients with ACS were initially included on the time of admission to the Coronary Unit of the Instituto Nacional de Cardiología in Mexico City, from February to May 2016, before any invasive procedure, imaging study, diuretic or anti-platelet therapy. White blood count, hemoglobin, NT-ProBNP, troponin I, C-reactive protein, albumin, glucose, Na+, K+, blood urea nitrogen (BUN), total cholesterol, HDL, LDL, triglycerides, creatinine (Cr), endothelin-1 (ET-1), leukotriene-B4, matrix metalloproteinase-2 and -9, tissue inhibitor of metalloproteinases-1, resolvin-D1 (RvD1), lipoxin-A4 (LXA4), interleukin-1ß, -6, -8, and -10 were measured. We finally enrolled 78 patients, and subsequently we identified 15 patients with ACS-AKI. Correlations were obtained by a Spearman rank test. Low-rank regression, splines regressions, and also protein-protein/chemical interactions and pathways analyses networks were performed. RESULTS: Positive correlations of ΔCr were found with BUN, admission Cr, GRACE score, IL-1ß, IL-6, NT-ProBNP and age, and negative correlations with systolic blood pressure, mean-BP, diastolic-BP and LxA4. In the regression analyses IL-10 and RvD1 had positive non-linear associations with ΔCr. ET-1 had also a positive association. Significant non-linear associations were seen with NT-proBNP, admission Cr, BUN, Na+, K+, WBC, age, body mass index, GRACE, SBP, mean-BP and Hb. CONCLUSION: Inflammation and its components play an important role in the worsening of renal function in ACS. IL-10, ET-1, IL-1ß, TnI, RvD1 and LxA4 represent mediators that might be associated with ACS-AKI. IL-6, ET-1, NT-ProBNP might represent crossroads for several physiopathological pathways involved in "de novo cardiac injury leading to de novo kidney injury".
Asunto(s)
Síndrome Coronario Agudo/complicaciones , Lesión Renal Aguda/etiología , Síndrome Cardiorrenal/etiología , Citocinas/sangre , Mediadores de Inflamación/sangre , Inflamación/etiología , Riñón/fisiopatología , Síndrome Coronario Agudo/sangre , Síndrome Coronario Agudo/diagnóstico , Lesión Renal Aguda/sangre , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/fisiopatología , Anciano , Biomarcadores/sangre , Síndrome Cardiorrenal/sangre , Síndrome Cardiorrenal/diagnóstico , Síndrome Cardiorrenal/fisiopatología , Femenino , Humanos , Inflamación/sangre , Inflamación/diagnóstico , Inflamación/fisiopatología , Masculino , México , Persona de Mediana Edad , Pronóstico , Mapas de Interacción de Proteínas , Factores de Riesgo , Transducción de SeñalRESUMEN
La omentina es una nueva adipocina a la que se le ha atribuido la capacidad de regular actividades metabólicas (sensibilidad a la insulina) y antiinflamatorias, ofreciendo protección cardiovascular en la obesidad y diabetes mellitus tipo 2. Por lo anterior, es importante conocer los mecanismos a través de los cuales confiere protección cardiovascular, con el objetivo de considerar la omentina como blanco o agente terapéutico en este escenario.
The omentin is an adipokine, which role is due to the capacity of regulate metabolic (insulin sensitivity) and anti-inflammatory activities, thus conferring vascular protection during obesity and diabetes mellitus type 2. By this, it is important to know the mechanisms by which omentin confers cardiovascular protection, with the purpose of establish omentin a possible therapeutic target or molecule on this scenario.
Asunto(s)
Humanos , Enfermedades Cardiovasculares/etiología , Citocinas/fisiología , Inflamación/etiología , Lectinas/fisiología , Resistencia a la Insulina/fisiología , Endotelio Vascular/fisiopatología , Metabolismo Energético , Proteínas Ligadas a GPI/fisiología , Obesidad/etiologíaRESUMEN
The omentin is an adipokine, which role is due to the capacity of regulate metabolic (insulin sensitivity) and anti-inflammatory activities, thus conferring vascular protection during obesity and diabetes mellitus type 2. By this, it is important to know the mechanisms by which omentin confers cardiovascular protection, with the purpose of establish omentin a possible therapeutic target or molecule on this scenario.