title: Vascular endothelial growth factor and monocyte chemoattractant protein-1 levels unaltered in symptomatic atherosclerotic carotid plaque patients from north India.
abstract: We aimed to identify the role of vascular endothelial growth factor (VEGF) and monocyte chemoattractant protein (MCP-1) as a serum biomarker of symptomatic carotid atherosclerotic plaque in North Indian population. Individuals with symptomatic carotid atherosclerotic plaque have high risk of ischemic stroke. Previous studies from western countries have shown an association between VEGF and MCP-1 levels and the incidence of ischemic stroke. In this study, venous blood from 110 human subjects was collected, 57 blood samples of which were obtained from patients with carotid plaques, 38 neurological controls without carotid plaques, and another 15 healthy controls who had no history of serious illness. Serum VEGF and MCP-1 levels were measured using commercially available enzyme-linked immunosorbent assay. We also correlated the data clinically and carried out risk factor analysis based on the detailed questionnaire obtained from each patient. For risk factor analysis, a total of 70 symptomatic carotid plaque cases and equal number of age and sex matched healthy controls were analyzed. We found that serum VEGF levels in carotid plaque patients did not show any significant change when compared to either of the controls. Similarly, there was no significant upregulation of MCP-1 in the serum of these patients. The risk factor analysis revealed that hypertension, diabetes, and physical inactivity were the main correlates of carotid atherosclerosis (p < 0.05). Prevalence of patients was higher residing in urban areas as compared to rural region. We also found that patients coming from mountain region were relatively less vulnerable to cerebral atherosclerosis as compared to the ones residing at non mountain region. On the contrary, smoking, obesity, dyslipidemia, alcohol consumption, and tobacco chewing were not observed as the determinants of carotid atherosclerosis risk in North India (p > 0.05). We conclude that the pathogenesis of carotid plaques may progress independent of these inflammatory molecules. In parallel, risk factor analysis indicates hypertension, diabetes, and sedentary lifestyle as the most significant risk factors of ischemic stroke identified in North India. This could be helpful in early identification of subjects at risk for stroke and devising health care strategies.
authors.affiliation: Department of Neurology, Post Graduate Institute of Medical Education and Research Chandigarh, India.
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Khurana
authors.forename: Deepali
authors.initials: D
authors.lastname: Mathur
authors.forename: Sudesh
authors.initials: S
authors.lastname: Prabhakar
authors.forename: Keshav
authors.initials: K
authors.lastname: Thakur
authors.forename: Akshay
authors.initials: A
authors.lastname: Anand
keywords: carotid atherosclerotic plaque; enzyme-linked immunosorbent assay; monocyte chemoattractant protein; serum protein levels; vascular endothelial growth factor
references.citation: JAMA. 1993 May 5;269(17):2214
references.pmid: 8474198
references.citation: J Epidemiol Community Health. 1985 Dec;39(4):325-9
references.pmid: 4086963
references.citation: Stroke. 2009 Apr;40(4):1212-8
references.pmid: 19228849
references.citation: Circulation. 1998 Sep 8;98(10):946-52
references.pmid: 9737513
references.citation: J Neuropathol Exp Neurol. 1998 Sep;57(9):874-82
references.pmid: 9737551
references.citation: Stroke. 1993 Sep;24(9):1366-71
references.pmid: 8362432
references.citation: Stroke. 1993 May;24(5):639-46
references.pmid: 8488517
references.citation: Anadolu Kardiyol Derg. 2007 Jun;7(2):152-7
references.pmid: 17513211
references.citation: Pharmacol Rev. 2004 Dec;56(4):549-80
references.pmid: 15602010
references.citation: Neurosci Lett. 1998 Jun 19;249(2-3):79-82
references.pmid: 9682821
references.citation: N Engl J Med. 1992 Jan 23;326(4):242-50
references.pmid: 1727977
references.citation: J Exp Med. 2002 Dec 2;196(11):1497-506
references.pmid: 12461084
references.citation: Neurology. 1993 Sep;43(9):1839-51
references.pmid: 8414045
references.citation: Eur J Public Health. 2002 Sep;12(3):171-6
references.pmid: 12232954
references.citation: Lancet. 1997 May 3;349(9061):1269-76
references.pmid: 9142060
references.citation: MMWR Morb Mortal Wkly Rep. 2012 May 25;61(20):379-82
references.pmid: 22622094
references.citation: Stroke. 2001 Jan;32(1):77-83
references.pmid: 11136918
references.citation: Circulation. 2003 Jun 24;107(24):3109-16
references.pmid: 12821592
references.citation: Clin Sci (Lond). 2002 Feb;102(2):187-94
references.pmid: 11834138
references.citation: Stroke. 1989 Dec;20(12):1691-3
references.pmid: 2595731
references.citation: Stroke. 1994 Jan;25(1):51-9
references.pmid: 8266383
references.citation: Mediators Inflamm. 2005 Aug 14;2005(3):175-9
references.pmid: 16106105
references.citation: Lancet. 1967 Apr 8;1(7493):753-4
references.pmid: 4164123
references.citation: Am J Epidemiol. 1998 Feb 1;147(3):259-68
references.pmid: 9482500
references.citation: J Intern Med. 1989 May;225(5):293-6
references.pmid: 2732669
references.citation: Lancet. 2005 Jun 25-Jul 1;365(9478):2160-1
references.pmid: 15978910
references.citation: JAMA. 2000 Jun 14;283(22):2961-7
references.pmid: 10865274
references.citation: Neurochem Int. 2012 May;60(6):592-6
references.pmid: 22394692
references.citation: JAMA. 1979 May 11;241(19):2035-8
references.pmid: 430798
references.citation: N Engl J Med. 1987 Aug 27;317(9):521-6
references.pmid: 3614303
references.citation: Diabetes. 1999 Nov;48(11):2229-39
references.pmid: 10535459
references.citation: Neuroepidemiology. 2008;31(4):254-61
references.pmid: 18931521
references.citation: J Am Coll Cardiol. 1990 Jun;15(7):1559-63
references.pmid: 2345235
references.citation: N Engl J Med. 1999 Jan 14;340(2):115-26
references.pmid: 9887164
references.citation: Sports Med. 1997 Apr;23(4):211-7
references.pmid: 9160478
references.citation: Stroke. 1994 May;25(5):951-7
references.pmid: 8165689
references.citation: Diabetes. 1999 May;48(5):1131-7
references.pmid: 10331420
references.citation: Stroke. 1998 Jul;29(7):1341-6
references.pmid: 9660384
references.citation: Stroke. 1996 Mar;27(3):373-80
references.pmid: 8610298
references.citation: Stroke. 2003 Dec;34(12):2792-5
references.pmid: 14615625
references.citation: Clin Infect Dis. 1998 Mar;26(3):719-34
references.pmid: 9524851
references.citation: Lab Invest. 1999 Apr;79(4):417-25
references.pmid: 10211994
references.citation: Stroke. 1992 Nov;23(11):1551-5
references.pmid: 1440701
references.citation: Neuroimaging Clin N Am. 1996 Nov;6(4):801-10
references.pmid: 8824132
references.citation: Stroke. 2000 Aug;31(8):1863-70
references.pmid: 10926948
references.citation: Vasc Med. 1997;2(2):115-25
references.pmid: 9546953
references.citation: BMJ. 1992 Mar 7;304(6827):597-601
references.pmid: 1559088
references.citation: Nat Med. 2001 Apr;7(4):425-9
references.pmid: 11283668
references.citation: J Cell Biochem. 1991 Nov;47(3):211-8
references.pmid: 1791185
references.citation: Am J Med. 1991 Apr;90(4):489-97
references.pmid: 2012089
references.citation: Int J Epidemiol. 2006 Dec;35(6):1522-9
references.pmid: 16997852
references.citation: Arterioscler Thromb Vasc Biol. 2003 Nov 1;23(11):1996-2001
references.pmid: 14500291
references.citation: BMJ. 1989 Mar 25;298(6676):789-94
references.pmid: 2496858
references.citation: JAMA. 1987 May 1;257(17):2318-24
references.pmid: 3553628
references.citation: J Clin Epidemiol. 1999 Jul;52(7):677-84
references.pmid: 10391661
references.citation: Neurol India. 1973 Mar;21(1):11-8
references.pmid: 4764474
references.citation: Am J Pathol. 1995 May;146(5):1029-39
references.pmid: 7538264
references.citation: Circulation. 1996 Nov 1;94(9):2057-63
references.pmid: 8901651