title: ACTH- and cortisol-associated neutrophil modulation in coronary artery disease patients undergoing stent implantation.
abstract: BACKGROUND
  Psychosocial stress and activation of neutrophil granulocytes are increasingly recognized as major risk factors of coronary artery disease (CAD), but the possible relationship of these two factors in CAD patients is largely unexplored. Activation of neutrophils was reported to be associated with stenting; however, the issue of neutrophil state in connection with percutaneous coronary intervention (PCI) is incompletely understood from the aspect of stress and its hypothalamic-pituitary-adrenal axis (HPA) background. Thus, we aimed to study cortisol- and ACTH-associated changes in granulocyte activation in patients undergoing PCI.
  
  
  RESULTS
  Blood samples of 21 stable angina pectoris (SAP) and 20 acute coronary syndrome (ACS) patients were collected directly before (pre-PCI), after (post-PCI) and on the following day of PCI (1d-PCI). Granulocyte surface L-selectin, CD15 and (neutrophil-specific) lactoferrin were analysed by flow cytometry. Plasma cortisol, ACTH, and lactoferrin, IL-6 were also assayed. In both groups, pre- and post-PCI ratios of lactoferrin-bearing neutrophils were relatively high, these percentages decreased substantially next day; similarly, 1d-PCI plasma lactoferrin was about half of the post-PCI value (all p≤0.0001). Post-PCI ACTH was reduced markedly next day, especially in ACS group (SAP: p<0.01, ACS: p≤0.0001). In ACS, elevated pre-PCI cortisol decreased considerably a day after stenting (p<0.01); in pre-PCI samples, cortisol correlated with plasma lactoferrin (r∼0.5, p<0.05). In 1d-PCI samples of both groups, ACTH showed negative associations with the ratio of lactoferrin-bearing neutrophils (SAP: r = -0.601, p<0.005; ACS: r = -0.541, p<0.05) and with plasma lactoferrin (SAP: r = -0.435, p<0.05; ACS: r = -0.609, p<0.005).
  
  
  CONCLUSIONS
  Pre- and post-PCI states were associated with increased percentage of activated/degranulated neutrophils indicated by elevated lactoferrin parameters, the 1d-PCI declines of which were associated with plasma ACTH in both groups. The correlation of plasma cortisol with plasma lactoferrin in the extremely stressed ACS before stenting, however, suggests an association of cortisol with neutrophil activation.
authors: Department of Biochemistry, Medical Faculty, University of Szeged, Szeged, Hungary. keresztes.margit@med.u-szeged.hu
authors: Margit
authors: M
authors: Keresztes
authors: Tamás
authors: T
authors: Horváth
authors: Imre
authors: I
authors: Ocsovszki
authors: Imre
authors: I
authors: Földesi
authors: Gyöngyi
authors: G
authors: Serfőző
authors: Krisztina
authors: K
authors: Boda
authors: Imre
authors: I
authors: Ungi
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000601:surgery; D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060050:Angina, Stable / Q000097:blood / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000601:surgery*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D019041:L-Selectin / Q000097:blood; D007781:Lactoferrin / Q000097:blood; D016256:Lewis X Antigen / Q000097:blood; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology*; D062645:Percutaneous Coronary Intervention; D015607:Stents
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D016256:Lewis X Antigen; D019041:L-Selectin; D000324:Adrenocorticotropic Hormone; D007781:Lactoferrin; D006854:Hydrocortisone
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