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Stroke ; 38(8): 2247-53, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17626901

RESUMO

BACKGROUND AND PURPOSE: Recently we found that the incidence of restenosis after carotid endarterectomy was significantly higher in patients homozygous for the normal genotype of mannose-binding lectin (MBL2) than in with patients with MBL2 variant genotypes. Several growth factors are also known to contribute to restenosis. Therefore, we investigated whether early postoperative changes in serum vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and platelet-derived growth factor (PDGF) concentrations and MBL2 genotypes interact in the development of restenosis. METHODS: Eighty-two patients who underwent carotid eversion endarterectomy and were followed up by carotid duplex scan sonography for 14 months were studied. Growth factors were measured preoperatively and 4 days after surgery. RESULTS: Pronounced significant increases in both VEGF and PDGF predicted restenosis but only in patients who were homozygous for the normal MBL2 genotype. In this group, the adjusted odds ratios of restenosis at 14 months in patients with high versus low early VEGF and PDGF increases were 27.73 (2.42 to 317.26) and 9.23 (1.45 to 58.70), respectively. CONCLUSIONS: These findings indicate that the development of restenosis depends on both complement activation regulated by the MBL2 gene and pathologic processes leading to enhanced production of VEGF and PDGF during the very early postoperative period.


Assuntos
Artérias Carótidas/fisiopatologia , Estenose das Carótidas/sangue , Estenose das Carótidas/genética , Lectina de Ligação a Manose/genética , Fator de Crescimento Derivado de Plaquetas/metabolismo , Fator A de Crescimento do Endotélio Vascular/sangue , Idoso , Artérias Carótidas/patologia , Artérias Carótidas/cirurgia , Estenose das Carótidas/cirurgia , Proteínas do Sistema Complemento/metabolismo , Análise Mutacional de DNA , Endarterectomia das Carótidas/estatística & dados numéricos , Fator de Crescimento Epidérmico/sangue , Feminino , Marcadores Genéticos/fisiologia , Predisposição Genética para Doença/genética , Testes Genéticos , Genótipo , Oclusão de Enxerto Vascular/sangue , Oclusão de Enxerto Vascular/genética , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Regulação para Cima/fisiologia
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