title: [Clinical significance of plasma concentration of macrophage colony-stimulating factor in patients with vasospastic angina].
abstract: OBJECTIVE
  The concentration of macrophage colony-stimulating factor (M-CSF), an inflammatory cytokine, increases with the progression of coronary lesions, but no clinical investigations have evaluated the relationship to coronary vascular tone. The present study investigated the relationship between M-CSF and vasoreactivity of the coronary arteries in patients with vasospastic angina.
  
  
  METHODS
  Vasospastic angina (VSA) was characterized by transient chest pain and ischemic ST segment changes at rest, or by a positive result in spasm provocation testing with acetylcholine. The subjects were 24 patients with stable VSA(inactive VSA group) treated on an outpatient basis, 31 VSA patients hospitalized with unstable angina (active VSA group), and 13 healthy subjects(control group). The sensitivity of determination of plasma M-CSF in blood was 40 pg/ml. The levels of this factor in each group were compared. Based on the findings of the acetylcholine vasospasm-induction test, patients were divided into those with single-vessel vasospasm and those with multivessel vasospasm, and, according to the dose of acetylcholine required to induce spasm, into high- and low-dose groups. Plasma M-CSF levels in each group were compared.
  
  
  RESULTS
  Mean plasma M-CSF was 598 +/- 180 pg/ml in the inactive VSA group, 775 +/- 194 pg/ml in the active VSA group, and 632 +/- 103 pg/ml in the control group. The mean plasma M-CSF level in the active VSA group was significantly higher than that in the inactive VSA group(p < 0.01). Mean plasma M-CSF level in the single-vessel and multivessel vasospasm groups was highest for active VSA patients with multivessel vasospasm (872 +/- 173 pg/ml). The relationship with the acetylcholine induction dose clarified that plasma M-CSF levels were highest in patients with active VSA in the acetylcholine low-dose group (825 +/- 177 pg/ml, p < 0.001).
  
  
  CONCLUSIONS
  Plasma M-CSF concentration reflects the vasoreactivity of coronary spasm in the VSA group, and may be an indicator of the severity of coronary endothelial dysfunction.
authors.affiliation: First Department of Internal Medicine, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8603.
authors.forename: Masato
authors.initials: M
authors.lastname: Tomimura
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Saitoh
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kishida
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kusama
authors.forename: Teruo
authors.initials: T
authors.lastname: Takano
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000097:blood*; D003329:Coronary Vasospasm / Q000097:blood*; D005260:Female; D006801:Humans; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood*; D008297:Male; D008875:Middle Aged
chemical_list: D016173:Macrophage Colony-Stimulating Factor