■对于高度狭窄(≥70%)的患者,必须进行颈动脉内膜切除术(CEA)以预防即将发生的血管和脑事件。在意大利国家项目时代的框架内。It,我们提出了一项初步研究,旨在发现具有颈动脉狭窄预测潜力的分子特征,比较65+无症状和有症状的住院患者.
■共纳入42名住院患者,包括26名男性和16名女性,平均年龄74±6岁。16例颈动脉狭窄≥70%的有症状和26例无症状的住院患者接受了CEA,根据欧洲血管外科学会和血管外科医师学会的建议。获得来自相同个体的斑块活检和外周血样品。对所有住院患者进行了血液生物化学分析,和血浆细胞因子/分子,如microRNAs(miR),IL-6,sIL-6Ra,sgp130,肌肉生长抑制素(GDF8),卵泡抑素,激活素A,CXCL9、FGF21和纤连蛋白,使用ELISA标准技术进行测量。在发现阶段获得了MiR谱,包括四名有症状的和四名无症状的住院患者(血浆和斑块样本),测试734MIRs。通过在总组群中的RT-qPCR分析验证了从谱分析比较中出现的MiR。
■两组住院患者的血c-miRs-126-5p和-1271-5p的表达水平不同(但在其斑块中没有),在有症状的受试者中表现得更多。两组之间有三种细胞因子:IL-6,GDF8和CXCL9。使用基于机器学习的方法进行接收器工作特性(ROC)分析,最重要的血液分子特征包括白蛋白,C反应蛋白(CRP),单核细胞的百分比,和CXCL9,允许区分两组(AUC=0.83,95%c.i.[0.85,0.81],p=0.0028)。分子特征的潜力将在第二组受监测的患者中进行测试,允许应用预测模型并最终评估可评估的筛查测试的成本/收益。
UNASSIGNED: Carotid endarterectomy (CEA) for the prevention of upcoming vascular and cerebral events is necessary in patients with high-grade stenosis (≥70%). In the framework of the Italian National project Age.It, a pilot
study was proposed aiming at the discovery of a molecular signature with predictive potential of carotid stenosis comparing 65+ asymptomatic and symptomatic inpatients.
UNASSIGNED: A total of 42 inpatients have been enrolled, including 26 men and 16 women, with a mean age of 74 ± 6 years. Sixteen symptomatic and 26 asymptomatic inpatients with ≥70% carotid stenosis underwent CEA, according to the recommendations of the European Society for Vascular Surgery and the Society for Vascular Surgeons. Plaque biopsies and peripheral blood samples from the same individuals were obtained. Hematobiochemical analyses were conducted on all inpatients, and plasma cytokines/molecules, such as microRNAs (miRs), IL-6, sIL-6Ralpha, sgp130, myostatin (GDF8), follistatin, activin A,
CXCL9, FGF21, and fibronectin, were measured using the ELISA standard technique. MiR profiles were obtained in the discovery phase including four symptomatic and four asymptomatic inpatients (both plasma and plaque samples), testing 734 miRs. MiRs emerging from the profiling comparison were validated through RT-qPCR analysis in the total cohort.
UNASSIGNED: The two groups of inpatients differ in the expression levels of blood c-miRs-126-5p and -1271-5p (but not in their plaques), which are more expressed in symptomatic subjects. Three cytokines were significant between the two groups: IL-6, GDF8, and
CXCL9. Using receiver operating characteristic (ROC) analysis with a machine learning-based approach, the most significant blood molecular signature encompasses albumin, C-reactive protein (CRP), the percentage of monocytes, and
CXCL9, allowing for the distinction of the two groups (AUC = 0.83, 95% c.i. [0.85, 0.81], p = 0.0028). The potential of the molecular signature will be tested in a second cohort of monitored patients, allowing the application of a predictive model and the final evaluation of cost/benefit for an assessable screening test.