title: High rate of early restenosis after carotid eversion endarterectomy in homozygous carriers of the normal mannose-binding lectin genotype.
abstract: OBJECTIVE
  Mannose-binding lectin (MBL) is thought to influence the pathophysiology of cardiovascular disease by decreasing the risk of advanced atherosclerosis and by contributing to enhanced ischemia reperfusion injury. Thus, we investigated the role of MBL in restenosis after eversion endarterectomy in patients with severe carotid atherosclerosis.
  
  
  METHODS
  In a prospective study, 123 patients who underwent carotid endarterectomy were followed-up by carotid duplex scan (CDS) sonography for 14 months. In a retrospective study, we examined 17 patients and 29 patients, respectively, who had or had not at least 50% restenosis 29 months after carotid eversion endarterectomy. MBL genotypes were analyzed by a polymerase chain reaction-based method, and MBL serum concentrations were measured.
  
  
  RESULTS
  In the prospective study in the patients homozygous for the normal MBL genotype, CDS values were significantly higher after 14 months of follow-up compared with the values measured 6 weeks after surgery (P<0.001). In contrast, only a slight increase was registered in patients carrying MBL variant alleles. The differences were much more pronounced in female than in male patients. Similar differences were observed when patients with high and low MBL serum concentrations were compared. In the retrospective study, a significant increase in the frequency of MBL variant genotypes was observed in patients not experiencing restenosis compared with the patients with restenosis (P=0.007).
  
  
  CONCLUSIONS
  These results indicate that reoccurrence of stenosis after carotid endarterectomy is partially genetically determined and imply that MBL contributes significantly to the pathophysiology of this condition.
authors.affiliation: Third Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Rugonfalvi-Kiss
authors.forename: Edit
authors.initials: E
authors.lastname: Dósa
authors.forename: Hans O
authors.initials: HO
authors.lastname: Madsen
authors.forename: Valéria
authors.initials: V
authors.lastname: Endrész
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Prohászka
authors.forename: Judit
authors.initials: J
authors.lastname: Laki
authors.forename: István
authors.initials: I
authors.lastname: Karádi
authors.forename: Eva
authors.initials: E
authors.lastname: Gönczöl
authors.forename: László
authors.initials: L
authors.lastname: Selmeci
authors.forename: László
authors.initials: L
authors.lastname: Romics
authors.forename: George
authors.initials: G
authors.lastname: Füst
authors.forename: László
authors.initials: L
authors.lastname: Entz
authors.forename: Peter
authors.initials: P
authors.lastname: Garred
mesh_terms: D000368:Aged; D000483:Alleles; D016893:Carotid Stenosis / Q000453:epidemiology / Q000209:etiology / Q000235:genetics*; D016894:Endarterectomy, Carotid; D005260:Female; D006580:Genetic Carrier Screening; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006720:Homozygote; D006801:Humans; D008297:Male; D037601:Mannose-Binding Lectin / Q000097:blood / Q000235:genetics*; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D037601:Mannose-Binding Lectin