Macrophage migration inhibitory factor is enhanced in acute coronary syndromes and is associated with the inflammatory response.
BACKGROUND
Chronic inflammation promotes atherosclerosis in cardiovascular disease and is a major prognostic factor for patients undergoing percutaneous coronary intervention (PCI). Macrophage migration inhibitory factor (MIF) is involved in the progress of atherosclerosis and plaque destabilization and plays a pivotal role in the development of acute coronary syndromes (ACS). Little is known to date about the clinical impact of MIF in patients with symptomatic coronary artery disease (CAD).


RESULTS
In a pilot study, 286 patients with symptomatic CAD (n = 119 ACS, n = 167 stable CAD) undergoing PCI were consecutively evaluated. 25 healthy volunteers served as control. Expression of MIF was consecutively measured in patients at the time of PCI. Baseline levels of interleukin 6 (IL-6), "regulated upon activation, normal T-cell expressed, and secreted" (RANTES) and monocyte chemoattractant protein-1 (MCP-1) were measured by Bio-Plex Cytokine assay. C-reactive protein (CRP) was determined by Immunoassay. Patients with ACS showed higher plasma levels of MIF compared to patients with stable CAD and control subjects (median 2.85 ng/mL, interquartile range (IQR) 3.52 versus median 1.22 ng/mL, IQR 2.99, versus median 0.1, IQR 0.09, p<0.001). Increased MIF levels were associated with CRP and IL-6 levels and correlated with troponin I (TnI) release (spearman rank coefficient: 0.31, p<0.001). Patients with ACS due to plaque rupture showed significantly higher plasma levels of MIF than patients with flow limiting stenotic lesions (p = 0.002).


CONCLUSIONS
To our knowledge this is the first study, demonstrating enhanced expression of MIF in ACS. It is associated with established inflammatory markers, correlates with the extent of cardiac necrosis marker release after PCI and is significantly increased in ACS patients with "culprit" lesions. Further attempts should be undertaken to characterize the role of MIF for risk assessment in the setting of ACS.
Kardiologie und Kreislauferkrankungen, Medizinische Klinik III, Eberhard Karls Universität, Tübingen, Germany.
Iris I
II
Müller
Karin A L
KA
Müller
Heiko
H
Schönleber
Athanasios
A
Karathanos
Martina
M
Schneider
Rezo
R
Jorbenadze
Boris
B
Bigalke
Meinrad
M
Gawaz
Tobias
T
Geisler
D054058:Acute Coronary Syndrome / Q000097:blood* / Q000276:immunology*; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D018932:Chemokine CCL2 / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood; D005260:Female; D006801:Humans; D007118:Immunoassay; D007249:Inflammation / Q000097:blood* / Q000276:immunology*; D015850:Interleukin-6 / Q000097:blood; D008263:Macrophage Migration-Inhibitory Factors / Q000097:blood*; D008297:Male; D008875:Middle Aged
C111835:CCL2 protein, human; D018932:Chemokine CCL2; D015850:Interleukin-6; D008263:Macrophage Migration-Inhibitory Factors; D002097:C-Reactive Protein