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Activador del receptor soluble del ligando del factor nuclear-kappa B y riesgo de enfermedad cardiovascular
Stefan Kiechl1, Georg Schett, Judith Schwaiger
1Department of Neurology, Innsbruck Medical University, Anichstr 35, A-6020 Innsbruck, Austria. Stefan.Kiechl@i-med.ac.at
Circulation
|July 11, 2007
Resumen
El elevado activador del receptor soluble del ligando del factor nuclear-kappaB (RANKL) predice el riesgo de enfermedad cardiovascular. Este hallazgo apoya el papel de RANKL en la enfermedad vascular, independientemente de la gravedad de la aterosclerosis.
Área de la Ciencia:
- Ciencias Cardiovasculares Ciencias Cardiovasculares
- Inmunología Inmunología.
- Epidemiología La epidemiología.
Sus antecedentes:
- La sobreexpresión del receptor activador del ligando del factor nuclear-kappaB (RANKL) está relacionada con lesiones ateroscleróticas vulnerables.
- Se supone que RANKL impulsa la inestabilidad de la placa, promoviendo la degradación de la matriz, la quimiotaxis de monocitos / macrófagos y la calcificación vascular.
Objetivo del estudio:
- Investigar la asociación entre los niveles de RANKL solubles y el riesgo de enfermedad cardiovascular (ECV).
- Para determinar si RANKL predice el riesgo vascular independientemente de los factores de riesgo tradicionales y la gravedad de la aterosclerosis.
Principales métodos:
- Estudio Bruneck prospectivo basado en la población con 909 participantes (de 40 a 79 años) en el inicio de la investigación (1990).
- Los niveles de RANKL solubles en suero medidos en la línea de base.
- Los eventos de enfermedades cardiovasculares (accidente cerebrovascular isquémico, AIT, infarto de miocardio, muerte vascular) se registraron meticulosamente desde 1990 hasta 2005.
Principales resultados:
- La RANKL soluble basal fue un predictor altamente significativo del riesgo vascular (HR ajustado 1,27 por unidad de aumento, P<0,001).
- La importancia predictiva se mantuvo independiente de la proteína C reactiva, la osteoprotegerina y la gravedad de la aterosclerosis carotídea.
- RANKL soluble no mostró asociación con la aterosclerosis de la arteria carótida o femoral.
Conclusiones:
- Los datos epidemiológicos a gran escala apoyan el papel de RANKL en las enfermedades cardiovasculares.
- Los hallazgos sugieren que RANKL puede promover la desestabilización de la placa y la ruptura, en lugar de causar directamente la aterosclerosis.
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