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The involvement of IL-6, IL-8, TNF-alfa and TGF-beta associated with the acute phase inflammatory marker (CRP) as predictors of restenosis in stents following percutaneous transluminal peripheral angioplasty

Grant number: 11/01429-5
Support type:Regular Research Grants
Duration: July 01, 2011 - June 30, 2013
Field of knowledge:Health Sciences - Medicine - Surgery
Principal Investigator:Edwaldo Edner Joviliano
Grantee:Edwaldo Edner Joviliano
Home Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Atherosclerotic disease remains the leading cause of death in Western countries. It is characterized by an inflammatory and degenerative process in which an accumulation of cells, matrix fibers, lipids and tissue debris in the intima may lead to a narrowing of the lumen and obstruction of blood flow or ulceration, embolization and thrombosis. Cytokines are proteins secreted by cells in the natural and acquired immunity that can be produced in response to different microorganisms and other antigens, and stimulate different responses of cells involved in immunity and inflammation. Peripheral arterial disease (PAD) is characterized by the deposition of fat, calcium and other elements in the arterial wall, reducing its size and bringing a shortage of blood to tissues irrigated by them. Peripheral transluminal angioplasty with stenting has become a viable option for the treatment of PAD in specific cases despite the recurrence of stenosis. Objective: To evaluate the plasma concentrations of IL-6, IL-8, TNF-alfa, TGF-beta and CRP as predictors of luminal narrowing and severity of restenosis in patients undergoing percutaneous peripheral intervention, 6 months after implantation of stents. Materials and methods: 40 selected patients in the clinic of Vascular Surgery HCFMRP-USP will be submitted to peripheral angioplasty and stenting of the iliac and femoropopliteal segments for treatment of PAD. These patients carry out surveillance tests (ultrasound and / or arteriography) on two occasions: 24h and 6 months after the surgical / clinical research aimed to assess re-stenosis, in addition to measurement of cytokines, CRP and blood count in the pre and post operative and 6 months. As a control, we will use 20 subjects who underwent angiography for diagnosis of PAD who do not have indication for angioplasty plus stent. Keywords: PAD, angioplasty, stent, restenosis, cytokine. (AU)