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Objective: By studying expression of CD36 mRNA in peripheral blood mononuclear cells(PBMCs) and sCD36 concentration changes in plasma in patients with coronary heart disease to investigate the relationship between CD36 and the severity of coronary atherosclerosis,and the possible role of CD36 in chronic inflammation of cardiovascular.Methods: Select 91 patients who have accepted coronary angiography (CAG) from January 2010 to March 2011 period in Fujian Provincial Hospital, including 56 males and 35 females, mean age 62.56±11.85 years.Record the physical data and biochemical indicators.The patients will be divided into four groups according to the results of CAG,the typical clinical manifestations,serum creatine kinase,cTnI,the electrocardiogram and so on.Four groups are as follws : control group,stable angina pectoris group(SAP group),unstable angina group(UAP group) and acute myocardial infarction group(AMI group).According to the evaluation criteria for coronary artery sub-image points from American Heart Association (AHA), and using Gensini scoring system, we will assess the degree of each coronary artery stenosis quantitatively. Collecting 10ml peripheral blood from the subjects in the fasting next morning who are admissed.And separating plasma and peripheral blood PBMCs, plasma stored at -80℃for testing sCD36.Amplified CD36 mRNA by reversed transcript polymerase chain reaction(RT-PCR) from PBMCs, the expression ofβ-actin was as an internal reference, comparing the changes in the expression of CD36 between the four groups.Result:1.Among each group,gender,smoking,age,SBP,DBP,FBS,PBG,TC and TG show no significant difference (P>0.05).LDL-C in AMI group is higher than the control group(P<0.05),but show no significant difference among other groups (P>0.05). HDL-C in AMI group is less than UAP group (P <0.05), and UAP group is also less than in SAP group (P<0.01). There was no significant difference between SAP group and control group (P>0.05).2.In AMI group,the Gensini scores is higher than in SAP group(P<0.01),also UAP group than SAP group(P<0.05). Between the AMI and UAP group show no significant difference (P>0.05).3.The expression of CD36 mRNA in PBMCs in patients with coronary heart disease is significantly increased.The AMI group is higher than UAP group(P <0.01), also UAP group than SAP group(P <0.01), and SAP group than the control group(P <0.05).4.The expression of CD36 mRNA is positively correlated with DBP, MAP, TC and TG(P<0.05), and is significantly negatively correlated with HDL-C(P<0.01).The multiple linear regression analysis showed that, DBP and HDL-C is the real CHD risk factors which impact the expression of CD36 mRNA (P <0.01).5.In UAP group, sCD36 is higher than the SAP group (P <0.01), and also SAP group than the control group (P <0.01).Between AMI group and UAP group is no significant difference (P> 0.05). In AMI group,hsCRP is higher than the UAP group (P <0.01), the same in the UAP group than the SAP group (P <0.01) and SAP group than the control group(P <0.01).6.sCD36 in plasma and CD36 mRNA expression in PBMCs was positively correlated (P <0.001).CD36 mRNA and sCD36 are significantly correlated with hsCRP (P <0.001).7.CD36 mRNA,sCD36, hsCRP increased when the Gensini score is increased(P <0.05).8.Multiple linear regression analysis shows that CD36 mRNA, sCD36, hsCRP, and HDL-C are independent predictors of the severity of coronary stenosis. Conclusion:1.The expression of CD36 mRNA in PBMCs in CHD patients is increased, indicating that patients with CHD was significantly activated in PBMCs. CD36 is sign of sub-inflammation state.And it involves in the chronic inflammatory process of CHD.2.hsCRP can upregulate the expression of CD36 mRNA in PBMCs and concentration changes of sCD36. hsCRP-CD36 function can speed up the progress of coronary artery plaque.3.sCD36 may be mostly derived from monocytes/macrophages (or monocytes/ macrophage-derived foam cells) and released into the circulation as a part of the whole CD36 molecule.sCD36 is the result of chronic inflammation of coronary vessels.While plaque ruptured,sCD36 is released particularly evident.So it is the biomarker of the unstable plaque.4.CD36,hsCRP and HDL-C are good predictors of the severity of coronary stenosis.CD36 signaling pathway will be a good clinical therapeutic target for CHD.
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