Kivonat:
BACKGROUND AND PURPOSE: Mannose-binding lectin (MBL) is thought
to influence the
pathophysiology of cardiovascular disease by decreasing the risk
of advanced
atherosclerosis and by contributing to enhanced ischemia
reperfusion injury.
Thus, we investigated the role of MBL in restenosis after
eversion endarterectomy
in patients with severe carotid atherosclerosis. METHODS: In a
prospective study,
123 patients who underwent carotid endarterectomy were followed-
up by carotid
duplex scan (CDS) sonography for 14 months. In a retrospective
study, we examined
17 patients and 29 patients, respectively, who had or had not at
least 50%
restenosis 29 months after carotid eversion endarterectomy. MBL
genotypes were
analyzed by a polymerase chain reaction-based method, and MBL
serum
concentrations were measured. RESULTS: In the prospective study
in the patients
homozygous for the normal MBL genotype, CDS values were
significantly higher
after 14 months of follow-up compared with the values measured 6
weeks after
surgery (P<0.001). In contrast, only a slight increase was
registered in patients
carrying MBL variant alleles. The differences were much more
pronounced in female
than in male patients. Similar differences were observed when
patients with high
and low MBL serum concentrations were compared. In the
retrospective study, a
significant increase in the frequency of MBL variant genotypes
was observed in
patients not experiencing restenosis compared with the patients
with restenosis
(P=0.007). CONCLUSIONS: These results indicate that reoccurrence
of stenosis
after carotid endarterectomy is partially genetically determined
and imply that
MBL contributes significantly to the pathophysiology of this
condition.