Nε-(carboxymethyl)lysine Concentration in Debris from Carotid Artery Stenting Correlates Independently with Signal Intensity on T1-Weighted Black-Blood Magnetic Resonance Images.
OBJECTIVE
Because magnetic resonance imaging (MRI) focuses on the morphological characteristics of carotid artery plaques, its diagnostic value with respect to plaque vulnerability is limited. We examined the correlation between Nε-(carboxymethyl)lysine (CML), a main chemical structure of advanced glycation end-products, and the vulnerability of plaques visualized on MRI scans.


METHODS
We enrolled 43 patients who had undergone carotid artery stenting (CAS) for carotid artery stenosis; all underwent MRI studies, including black-blood MRI and diffusion-weighted imaging (DWI). The signal intensity ratio (SIR) of plaques to adjacent sternocleidomastoid muscle (P/M) on T1- and T2-weighted images (T1WI, T2WI) was calculated. Protein samples were extracted from debris trapped by a filter device. The concentrations of CML and myeloperoxidase (MPO) were measured by solid-phase enzyme-linked immunosorbent assay.


RESULTS
The patients were classified into 2 groups based on their SIR-P/M on T1WI and T2WI scans. We observed a higher incidence of post-CAS DWI lesions in patients with a higher than a lower SIR-P/M on T1WI; the CML and MPO concentrations in their CAS debris were also higher. No such differences were seen in patients with a higher or lower SIR-P/M on T2WI scans. The concentration of CML in CAS debris correlated independently with the SIR-P/M on T1WI of the carotid plaques, and was related to the concentration of MPO in CAS debris.


CONCLUSIONS
Our findings suggest CML as a candidate molecular imaging probe for the identification of vulnerable plaques.
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Ayumu
A
Eto
General Medical Research Center, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Noriyuki
N
Sakata
Laboratory of Food and Regulation Biology, Department of Bioscience, School of Agriculture, Tokai University, Kumamoto, Japan.
Ryoji
R
Nagai
Laboratory of Food and Regulation Biology, Department of Bioscience, School of Agriculture, Tokai University, Kumamoto, Japan.
Jun-Ichi
JI
Shirakawa
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Ritsurou
R
Inoue
Academia, Industry and Government Collaborative Research Institute of Translational Medicine for Life Innovation, Fukuoka University, Fukuoka, Japan.
Fumiaki
F
Kiyomi
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan. Electronic address: k.nii@cis.fukuoka-u.ac.jp.
Kouhei
K
Nii
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Hiroshi
H
Aikawa
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Minoru
M
Iko
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Masanori
M
Tsutsumi
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Kimiya
K
Sakamoto
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Fumihiro
F
Hiraoka
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Takahumi
T
Mitsutake
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Hayatsura
H
Hanada
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Kiyoshi
K
Kazekawa
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002339:Carotid Arteries / Q000737:chemistry / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D016009:Chi-Square Distribution; D002853:Chromatography, Liquid; D038524:Diffusion Magnetic Resonance Imaging; D057505:Embolic Protection Devices; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016014:Linear Models; D008239:Lysine / Q000031:analogs & derivatives* / Q000097:blood; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D057054:Molecular Imaging; D015999:Multivariate Analysis; D009195:Peroxidase / Q000097:blood; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D053719:Tandem Mass Spectrometry; D016896:Treatment Outcome
D015415:Biomarkers; C048496:N(6)-carboxymethyllysine; D009195:Peroxidase; D008239:Lysine
Nε-(carboxymethyl)lysine; carotid artery stenting; debris; magnetic resonance imaging; myeloperoxidase; vulnerable plaque