Asemptomatik Karotis Arter Stenozu Olan Hastalarda Olası İmmün Modülasyonun ve Oksidatif Hasarın Değerlendirilmesi

Abstract

Asymptomatic carotid artery stenosis is usually detected by physicians in patients, coincidentally, during an ultrasound examination of the neck. Therefore, measurable biomarkers in blood are needed to define the presence and severity of atherosclerotic plaque in patients to identify and manage it. We hypothesized that biomarkers that indicate pathways related to the pathogenesis of atherosclerosis could be used to identify the presence and severity of atherosclerotic plaque. For this purpose, the levels of participants' plasma inflammatory and oxidative stress biomarkers were determined. Tryptophan, kynurenine, and neopterin levels were measured as relatively new biomarkers of inflammation in this study. Our study included 57 patients diagnosed with asymptomatic carotid artery stenosis and 28 healthy volunteers. Plasma kynurenine and tryptophan levels were measured with Liquid Chromatography-Mass Spectrometry/Mass Spectrometry (LCMS/MS). Plasma catalase (CAT), total superoxide dismutase (t-SOD), glutathione peroxidase (GPx), malondialdehyde (MDA), and neopterin levels were measured using the The enzyme- linked immunosorbent assay (ELISA) method. The kynurenine to tryptophan ratio, reflecting Indoleamine 2,3-dioxygenase (IDO) activity, was higher in patients than in healthy volunteers. Decreases in tryptophan levels and increases in kynurenine and neopterin levels were observed in patients who underwent carotid endarterectomy. In patients, MDA, CAT, and t-SOD levels were higher, while the GPx activity was lower. These differences were more significant in patients who underwent carotid endarterectomy. Increasing the kynurenine/tryptophan ratio and neopterin level in patients with asymptomatic carotid artery stenosis has been associated with the inflammatory state of patients. The oxidative stress and inflammatory biomarkers may be considered an effective diagnostic and prognostic tool for asymptomatic carotid artery stenosis.