This journal is
indexed in Scopus
Year 2021 Vol. 29 No 4
GENERAL & SPECIAL SURGERY
R.E. KALININ, I.A. SUCHKOV, A.V. SCHULKIN, E.A. KLIMENTOVA, A.A. EGOROV
INFLUENCE OF VARIOUS SURGICAL INTERVENTIONS ON VASCULAR WALL APOPTOSIS INDICES IN PATIENTS WITH ATHEROSCLEROSIS OF PERIPHERAL ARTERIES
I.P. Pavlov Ryazan State Medical University, Ryazan,
Objective. Assessment of apoptosis proteins Bcl-2 and Bax indices before and after the open vascular reconstructions and X-ray endovascular interventions in patients with the peripheral atherosclerosis of the arteries of the lower extremities.
Methods. The study included patients (n=40) with the peripheral atherosclerosis of the lower extremities arteries (stage III-IV) disease who underwent open surgery – group A, and patients (n=40) who underwent endovascular interventions – group B. Two apoptosis proteins were analyzed in blood serum: Bax and Bcl-2 initially before surgery, on the 1st day and after 1 month. The reference values of the studied parameters were determined in 40 healthy volunteers.
Results. Initial Bax protein index – 27.1 ng / ml (ð<0,001) were elevated in patients of group A and reduced Bax protein – 4.4 ng / ml (p=0.00008) in patients of group B compared with indices of healthy volunteers (16.5 ng / ml, 5.3 ng / ml, respectively). On the 1st day after the interventions in the patients of the operative groups there was an increasing tendency for Bax index to 35.6 ng / ml (p<0.001) – group A, to 25.6 ng/ml (p<0.001) – group B. By the end of 1st month, Bax was increased to 28 ng/ml (p<0.001) in patients of group A and Bcl-2 was reduced to 3.0 ng / ml (p=0.039) compared to the initial indices; in patients of group B, only protein Bax – 23.9 ng / ml (p<0.001) was increased.
Conclusion. Open and endovascular intervention on the arteries of the lower extremities leads to the activation of the pro-apoptotic protein Bax on the 1st day after surgery. In the postoperative period the open reconstruction leads to an evaluation of the pro-apoptotic potential in comparison with endovascular intervention in the form of increasing Bax protein and reducing Bcl-2 by the end of the first month.
- Alekian BG, Pokrovskii AV, Karapetian NG, Revishvili ASh. Sovremennye tendentsii razvitiia khirurgicheskogo i endovaskuliarnogo lecheniia bol’nykh s arterial’noi patologiei. Angiologiia i Sosudistaia Khirurgiia. 2019;25(4):55-63. http://www.angiolsurgery.org/magazine/2019/4/5.htm (In Russ.)
- Batyraliev TA, Fettser DV, Sidorenko BA, Boduroglu Y, Dokumaci B. Effect of design of standard metallic stents on neointimal hyperplasia and restenosis. Êàrdiologiia. 2014,54(2):75-78. (n Russ.)
- Strel’nikova EA, Trushkina PIu, Surov IIu, Korotkova NV, Mzhavanadze ND, Deev RV. Endothelium in vivo and in vitro. Part 1: histogenesis, structure, cytophysiology and key markers. Nauka Molodykh (Eruditio Juvenium). 2019,7(3):450-65. doi: 10.23888/HMJ201973450-465 (n Russ.)
- Egorova IE, Bakhtairova VI, Suslova AI. Molecular mechanisms of apoptosis involved in the development of different pathological processes Innovatsionnye Tenokhlogii v Farmatsii. 2019;(6):108-14. https://elibrary.ru/item.asp?id=38363905 ()n Russ.)
- Clarke MC, Littlewood TD, Figg N, Maguire JJ, Davenport AP, Goddard M, Bennett MR. Chronic apoptosis of vascular smooth muscle cells accelerates atherosclerosis and promotes calcification and medial degeneration. Circ Res. 2008 Jun 20;102(12):1529-38. doi: 10.1161/CIRCRESAHA.108.175976
- Kutuk O, Basaga H. Bcl-2 protein family: implications in vascular apoptosis and atherosclerosis. Apoptosis. 2006 Oct;11(10):1661-75. doi: 10.1007/s10495-006-9402-7
- Hockings C, Alsop AE, Fennell SC, Lee EF, Fairlie WD, Dewson G, Kluck RM. Mcl-1 and Bcl-xL sequestration of Bak confers differential resistance to BH3-only proteins. Cell Death Differ. 2018 Mar;25(4):721-34. doi: 10.1038/s41418-017-0010-6
- Kockx MM, De Meyer GR, Muhring J, Jacob W, Bult H, Herman AG. Apoptosis and related proteins in different stages of human atherosclerotic plaques. Circulation. 1998 Jun 16;97(23):2307-15. doi: 10.1161/01.cir.97.23.2307
- Isner JM, Kearney M, Bortman S, Passeri J. Apoptosis in human atherosclerosis and restenosis. Circulation. 1995 Jun 1;91(11):2703-11. doi: 10.1161/01.cir.91.11.2703.
- Spiguel LR, Chandiwal A, Vosicky JE, Weichselbaum RR, Skelly CL. Concomitant proliferation and caspase-3 mediated apoptosis in response to low shear stress and balloon injury. J Surg Res. 2010 Jun 1;161(1):146-55. doi: 10.1016/j.jss.2008.11.001
- Walsh K, Smith RC, Kim HS. Vascular cell apoptosis in remodeling, restenosis, and plaque rupture. Circ Res. 2000 Aug 4;87(3):184-88. doi: 10.1161/01.res.87.3.184
- Vladimirskaya TE, Shved IA, Demidchik YuE. Ratio of expression of the Bcl-2 and Bax proteins in the atherosclerotic coronary artery wall. Proceedings of the National Academy of Sciences of Belarus, Medical Series. 2015;(4):51-55. https://vestimed.belnauka.by/jour/article/view/213?locale=ru_RU (In Russ.)
- Wan L, Dai SH, Lai SQ, Liu LQ, Wang Q, Xu H, Wang WJ, Liu JC. Apoptosis, proliferation, and morphology during vein graft remodeling in rabbits. Genet Mol Res. 2016 Oct 5;15(4). doi: 10.4238/gmr.15048701
- Kalinin R.E., Suchkov I.A., Klimentova Å.A., et al. Apoptosis in vascular pathology: present and future. I.P. Pavlov Russian Medical Biological Herald. 2020;28(1):79-87. doi: 10.23888/PAVLOVJ202028179-87 (In Russ.)
390026, Russian Federation,
Ryazan, Vysokovoltnaya Str., 9,
Ryazan State Medical University,
the Department of Cardiovascular,
Operative Surgery and Topographic Anatomy,
tel.: +7 903ì836-24-17,
Suchkov Igor A.
Kalinin Roman E., MD, Professor, Rector, Head of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Topographic Anatomy, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
Suchkov Igor A., MD, Professor, Vice-Rector for Research and Innovative Development, Professor of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Topographic Anatomy, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
Shchul’kin Aleksey V., MD, Associate Professor of the Department of Pharmacology with the Course of Pharmacy of Continuing Professional Education Faculty, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
Klimentova Åmma A., PhD, Post-Graduate Student of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Topographic Anatomy, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
Egorov Andrey A., MD, Associate Professor of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Topographic Anatomy, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.