Restricted accessResearch articleFirst published online 2017-6-27
The role of GST polymorphism in reperfusion induced oxidative stress,inflammatory responses and clinical complications after surgical and percutaneous coronary intervention
BACKGROUND: Patients having coronary artery disease treated by coronary
bypass or PCI procedure are exposed to tissue damage because of the phenomenon called
reperfusion injury. Reperfusion injury can be characterized/monitored by oxidative stress
parameters, inflammatory markers and by post-operative complication rate.
OBJECTIVE: Beyond the obvious factors determining its severity (affected
myocardial mass, ischaemic time, collateral circulation etc.) we examined the GST enzyme
group’s most cardio selective member, GSTP1 and its genetic polymorphism if there is any
genetically determined preventive effect on the above-mentioned parameters.
MATERIALS AND METHODES: We have performed randomized prospective study in
the Heart Institute of Pecs with 862 patients, treated by coronary bypass or PCI
procedure. Blood samples were taken a day before, one hour, one day, one week after the
operation. Leucocyte count (WBC), myeloperoxidase (MPO), thiol group (SH); Superoxide
dismutase (SOD), malondialdehyde (MDA), reduced Glutathione (GSH) level was checked in
different periods of time as a comparison. The onset of myocardial damage and the
corresponding necro enzyme level changes were registered in the perioperative period. Our
patient’s GSTP1 allele pair combinations (A, B, or C) were determined by real time PCR
method.
RESULTS: In patients with GSTP1 AA genotype we have found significance level
reaching plasma concentration rise in SOD and MDA, and drop in GSH, SH. The CKMB
concentration rise in the post-operative 24 hours was significantly higher in the GSTP1 AA
group.
CONCLUSIONS: According to our results the AA allele combination can be
considered as a risk factor. GSTP1-AA allele pair has negative effect on
ischemia-reperfusion tolerance of the heart. In case of cardiovascular interventions, the
study of GST enzyme polymorphisms can be an independent risk stratification factor in
determining the perioperative risk in the future.
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