Elevated complement C3 is associated with early restenosis after eversion carotid endarterectomy

Gábor Széplaki; Lilian Varga; Judit Laki; Edit Doása; Hans O. Madsen; Zoltán Prohászka; Attila Szabó; György Acsády; László Selmeci; Peter Garred; George Füst; László Entz

doi:10.1160/TH06-05-0263

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2006; 96(04): 529-534
DOI: 10.1160/TH06-05-0263

Cardiovascular Biology and Cell Signalling

Schattauer GmbH

Elevated complement C3 is associated with early restenosis after eversion carotid endarterectomy

Gábor Széplaki

¹3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary

,

Lilian Varga

¹3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary

,

Judit Laki

¹3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary

,

Edit Doása

²Department of Cardiovascular Surgery, Semmelweis University, Budapest, Hungary

,

Hans O. Madsen

³Tissue-Typing Laboratory-7631, Department of Clinical Immunology, Rigshospitalet, Copenhagen, Denmark

,

Zoltán Prohászka

¹3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary

⁴Research Group of Metabolism and Atherosclerosis, Semmelweis University and Hungarian Academy of Sciences, Budapest, Hungary

,

Attila Szabó

²Department of Cardiovascular Surgery, Semmelweis University, Budapest, Hungary

,

György Acsády

²Department of Cardiovascular Surgery, Semmelweis University, Budapest, Hungary

,

László Selmeci

²Department of Cardiovascular Surgery, Semmelweis University, Budapest, Hungary

,

Peter Garred

³Tissue-Typing Laboratory-7631, Department of Clinical Immunology, Rigshospitalet, Copenhagen, Denmark

,

George Füst

¹3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary

⁴Research Group of Metabolism and Atherosclerosis, Semmelweis University and Hungarian Academy of Sciences, Budapest, Hungary

,

László Entz

²Department of Cardiovascular Surgery, Semmelweis University, Budapest, Hungary

› Author Affiliations

Abstract

Summary

Early restenosis following carotid endarterectomy (CEA) is an inflammatory process leading to myointimal hyperplasia of smooth muscle cells. The risk for restenosis is increased in homozygous carriers of the normal (A) allele of mannose-binding lectin (MBL2) gene. Our objective was to study the associ-ations of C3 and as control three non-complement acute-phase reactants (APRs) (C-reactive protein, haptoglobin and α2HS-glycoprotein) with early restenosis following CEA.We also considered, whether MBL2 genotype relates to C3 levels and to the risk of restenosis. Concentrations of the APRs were determined by radial immunodiffusion or immunoturbidimetric methods in 64 patients who underwent eversion CEA and were followed up with carotid duplex scan (CDS) examinations for at least one year. MBL2 genotypes were determined by a PCR-SSP method. C3 levels increased during the follow-up and correlated with the percentage of restenosis detected by CDS at 14 months postsurgery, in MBL2 A/A allele carriers. Patients with high C3 levels had nearly five-fold higher odds for the presence of significant restenosis (>50% reduction in diameter) even after adjusting for MBL2 genotype, age and gender. By contrast, no such associations were detected between the non-complement APRs and early restenosis. C3 is associated with and might have a direct role in the development of an early restenosis following CEA, which is partially related to an intact MBL lectin pathway, thus determining C3 levels might have clinical importance. On the other hand, our results indicate that the regulation of C3 differs from non-complement APRs.

Keywords

Complement C3 - mannose binding lectin - restenosis - carotid arteries - endarterectomy

Full Text

References

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