Parameters of mitochondrial pathway of apoptosis in serum and homogenate of vascular wall in patients with atherosclerosis of peripheral arteries
Aim. Determination of the amount of Bcl2 and Bax apoptosis proteins in the homogenate of the vascular wall and blood serum, and of their relationship in patients with obliterating atherosclerosis of the lower limb arteries (OALLA) with III stage of the disease. Materials and Methods. The study included 12 patients with III stage OALLA according to Pokrovsky-Fontaine classification. After follow-up examination, these patients underwent open surgical interventions on the arteries of the femoral-popliteal segment. According to signed informed consent, during the surgical intervention, the intraoperative samples of all three layers of the vascular wall were taken. A sample of the vessel was crushed, and a homogenate was prepared, in which expression of Bcl2 anti-apoptotic protein and Bax pro-apoptotic protein was determined by ELISA method. Samples of the vascular wall without visible signs of atherosclerosis taken from patients undergoing reconstructive surgery were used as a control for arteries. Initially, before the operation, the studied parameters were determined in blood serum using ELISA method. To determine the reference values of Bcl2 and Bax proteins, healthy volunteers were included in the study. Results. In the homogenate of the arterial wall without atherosclerotic changes (control sample), the amount of Bcl2 protein was 1.26 ng/ml, of Bax 3.8 ng/ml. In the homogenate of the arterial wall in the area of an atherosclerotic plaque, the amount of Bcl2 did not differ from the control sample and was 1.4 ng/ml (p=0.504), and the amount of Bax protein increased to 6.54 ng/ml (p=0.033). In healthy volunteers, Bcl2 and Bax values in serum were 5.2 ng/ml and 15.9 ng/ml, respectively. In patients with OALLA, the amount of Bax protein in blood serum increased to 26.7 ng/ml (p=0.009), with the level of Bcl2 4.96 ng/ml (p=0.761). Correlation analysis showed the relationship between the level of Bcl2 (r=+0.806), Bax (r=+0.699), Bax/Bcl2 (r=+0,642) in the homogenate of the vascular wall and in blood serum. Conclusions. In patients with III stage OALLA, the level of pro-apoptotic Bax protein was elevated both in the vascular wall and in the blood serum. The amount of Bcl2 and Bax apoptosis proteins in blood serum reflects their amount in the vascular wall in patients with OALLA.