Background: Cathepsin S (CTSS) is a cysteine protease involved in atherogenesis. We compared the plasma CTSS as well as other biomarkers of atherosclerosis in patients with abdominal aortic aneurysms (AAA) and aortoiliac occlusive disease (AOD), aiming to identify the underlying pathogenic mechanisms of the disease development. Also, we hypothesised that the level of plasma CTSS simultaneously increases with a decrease of plasma high-density lipoprotein cholesterol (HDL-C) values.
Methods: 33 patients with AAA and 34 patients with AOD were included in this study.
Results: There was no difference in the level of plasma CTSS between the two analysed groups (p=0.833). In the patients with AAA, the plasma CTSS was correlated with HDL-C (r = -0.377, p = 0.034) and total bilirubin (r =0.500, p = 0.003) while, unexpectedly, it was not correlated with cystatin C (Cys C) (r =0.083, p = 0.652). In the patients with AOD, the plasma CTSS correlated with triglycerides (r = 0.597, p< 0.001), only. When the patients were divided according to HDL-C (with HDL-C ≤0.90 and HDL-C >0.90 mmol/L), the plasma CTSS values differed among these groups (31.27 vs.25.61 μg/L, respectively, p<0.001).
Conclusions: These results provide the first evidence that CTSS negatively correlated with HDL-C and bilirubin in patients with AAA. It is possible that differences in the association of the CTSS and other markers of atherosclerosis can determine whether atherosclerotic aorta will develop dilatation or stenosis.
Uvod: Katepsin S (CTSS) je cisteinska proteaza uključena u aterogenezu. Uporedili smo plazmatski CTSS kao i druge biomarkere ateroskleroze kod pacijenata sa aneurizmom abdominalne aorte (AAA) i aorto ilijačnom okluzivnom bolešću (AOD) sa ciljem da se identifikuju osnovni patogeni mehanizmi razvoja bolesti. Takođe, pretpostavili smo da se nivo plazmatskog CTSS istovremeno povećava sa smanjenjem vrednosti holesterola plazmatskih lipoproteina visoke gustine (HDL-C).
Metode: Ova studija je obuhvatila 33 pacijenta sa AAA i 34 pacijenta sa AOD.
Rezultati: Nije bilo razlike u nivou plazmatskog CTSS izme|u dve analizirane grupe (p = 0,833). Kod pacijenata sa AAA, plazmatski CTSS je bio u korelaciji sa HDL-C (r = -0,377, p = 0,034) i ukupnim bilirubinom (r = - 0,500, p = 0,003), dok, neočekivano, nije bio u korelaciji sa cistatinom C (Cys C) (r = 0,083, p = 0,652). Kod pacijenata sa AOD, plazmatski CTSS je bio u korelaciji sa trigliceridima (r = 0,597,p <0.001). Kada su pacijenti podeljeni prema HDL-C (sa HDL-C ≤ 0,90 i HDL-C > 0,90 mmol/L), vrednosti plazmatskog CTSS su se razlikovale među grupama (31,27 naspram 25,61 μg/L, respektivno, p < 0,001).
Zaključak: Ovi rezultati pružaju prvi dokaz da je CTSS negativno povezan sa HDL-C i bilirubinom kod pacijenata sa AAA. Pretpostavka je da se na osnovu razlike u asocijaciji CTSS-a i drugih markera ateroskleroze može utvrditi da li će ateroskleroza aorte dovesti do dilatacije ili stenoze.
Keywords: HDL-C; abdominal aortic aneurysm; cathepsin S; cystatin C.