In this work, our primary objective was to examine the interrelationship among the serum level of chemokine (C-C motif) ligand 2 (CCL2) and plaque characteristics in coronary culprit lesions. The clinical data of 116 coronary heart disease patients who were hospitalized in the Department of Cardiology of Henan Province People's Hospital from February 2015 to June 2017 were retrospectively analyzed. The study population was subdivided according to the concentration of CCL2 into low CCL2 group and high CCL2 group. The levels of blood lipid, creatinine, and uric acid were measured, and patients underwent coronary angiography. The characteristics of the culprit lesions were detected by intravascular ultrasound, and the correlation between the serum markers and the characteristics of coronary artery plaque was analyzed. Moreover, the coronary artery disease dataset from the Gene Expression Omnibus database was downloaded and the genes regulated were analyzed by CCL2 using gene set enrichment analysis (GSEA). Patients with high CCL2 group had higher LDL-C level and L/H ratio, and lower HDL-C level than the low CCL2 group. Compared with low-level CCL2 group, coronary plaque in the high CCL2 group had higher eccentric plaque and plaque rupture, and thin cap fibroatheromas, fibrofatty and necrotic core and lower fibrous tissue. CCL2 was positively correlated with the percentage of fibrofatty and necrotic core, and negatively correlated with the percentage of fibrous tissue. Furthermore, GSEA analysis showed that samples with high CCL2 expression were enriched for genes involved in different pathways, such as cell adhesion molecules and Nod-like receptor signaling pathway. The CCL2 level was correlated with vulnerable plaques of coronary artery and had certain value in detecting vulnerable plaques. These results indicated that CCL2 could be regarded as a clinical prognostic biomarker for coronary artery disease.

Impact statement

Vulnerable plaques are plaques which are susceptible to rupture or thrombosis and trigger a series of adverse events such as coronary disorders. CCL2 is a soluble basic protein belonging to the CC subfamily. Previous studies have been investigated on the correlation between inflammatory factors and clinical events, but there are few studies on the correlation between CCL2 and plaque characteristics. Our study found that the high expression of CCL2 is involved in multiple processes in the genesis and progression of coronary artery disease, and would be a potential clinical prognostic indicator. In addition, high expression of CCL2 may be related to gene pathways such as Nod-like receptor signaling pathway, suggesting that CCL2 is involved in the inflammatory response and immune process of coronary artery disease.

中文翻译：

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单核细胞趋化蛋白-1/趋化因子（CC 基序）配体 2 与冠状动脉斑块特征之间的相关性。

在这项工作中，我们的主要目标是检查趋化因子（CC 基序）配体 2（CCL2）的血清水平与冠状动脉罪犯病变中斑块特征之间的相互关系。回顾性分析2015年2月至2017年6月河南省人民医院心内科住院的116例冠心病患者的临床资料。根据CCL2浓度将研究人群细分为低CCL2组和高CCL2组。测量血脂、肌酐和尿酸水平，并对患者进行冠状动脉造影。通过血管内超声检测罪犯病变的特征，并分析血清标志物与冠状动脉斑块特征的相关性。而且，下载来自基因表达综合数据库的冠状动脉疾病数据集，并通过 CCL2 使用基因集富集分析 (GSEA) 分析受调控的基因。高CCL2组患者的LDL-C水平和L/H比值较高，HDL-C水平低于低CCL2组。与低水平CCL2组相比，高CCL2组冠状动脉斑块偏心斑块和斑块破裂率较高，帽状纤维粥样硬化、纤维脂肪和坏死核心、纤维组织较低。CCL2与纤维脂肪和坏死核的百分比呈正相关，与纤维组织的百分比呈负相关。此外，GSEA 分析表明，高 CCL2 表达的样品富含参与不同途径的基因，例如细胞粘附分子和 Nod 样受体信号通路。CCL2水平与冠状动脉易损斑块相关，对检测易损斑块有一定价值。这些结果表明CCL2可以被视为冠状动脉疾病的临床预后生物标志物。

影响陈述

易损斑块是易破裂或血栓形成并引发一系列不良事件如冠状动脉疾病的斑块。CCL2是属于CC亚家族的可溶性碱性蛋白。既往研究探讨了炎症因子与临床事件的相关性，但关于CCL2与斑块特征相关性的研究较少。我们的研究发现，CCL2的高表达参与了冠状动脉疾病发生和发展的多个过程，可能是一个潜在的临床预后指标。此外，CCL2的高表达可能与Nod样受体信号通路等基因通路有关，提示CCL2参与冠状动脉疾病的炎症反应和免疫过程。