Coronary artery ectasia and inflammatory cytokines: Link with a predominant Th-2 immune response?

- We investigated the relation of IL-2, IL-4 and IL-6 with CAE and CAD.
- A Th-2 response with high IL-4 and IL-6 and low IL-2 was observed in CAE patients.
- Obstructive CAD showed a Th-1 response with significantly high IL-2 and low IL-4.
- High IL-4 and low IL-2 were the strongest independent factors associated with CAE.

ObjectiveThe role of inflammation in coronary artery ectasia (CAE) remains controversial. We evaluated the hypothesis that CAE might be associated with a specific pattern of T helper (Th) lymphocyte activation by measuring the Th-1 cytokine, interleukin-2 (IL-2) and the Th-2 cytokines, interleukin-4 (IL-4) and interleukin-6 (IL-6) in patients with CAE, obstructive coronary artery disease (CAD) and controls.MethodsSerum levels of IL-2, IL-4 and IL-6 were measured in 74 patients undergoing an elective cardiac catheterization due to angina pectoris and positive or equivocal non-invasive screening for cardiac ischaemia: 34 had CAE and non-obstructive CAD (Group A), 22 had obstructive CAD (Group B) and 18 had normal coronaries (Group C).ResultsGroup A had significantly higher IL-4 than Group B and Group C (p < 0.001 and p = 0.006, respectively). In contrast, Group A had markedly lower IL-2 than Group B and Group C (p < 0.001 for both comparisons). Group C had higher IL-4 and lower IL-2 than Group B (p < 0.001 for both comparisons). Interleukin-6 was significantly higher in Groups A and B compared to Group C (p < 0.001 for both comparisons), whilst it was comparable between Group A and Group B. Multivariate logistic regression analysis showed that higher levels of IL-4 and lower levels of IL-2 were the strongest independent predictors associated with CAE (OR: 3.846, CI: 1.677-8.822, p = 0.001 and OR: 0.567, CI: 0.387-0.831, p = 0.004, respectively).ConclusionsOur data demonstrates that Th-2 immune response, exhibited through increased IL-4 and low IL-2, constitutes a fundamental feature of CAE.