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NEUTROPHIL FUNCTION IN SOME CORONARY ARTERY DISEASE RISK FACTORS


Thesis Submitted in Partial Fulfilment for the Master Degree of Cardiology By
ESAM MOHAMED FAWZY EBRAHEIM

SUPERVISORS

ABDALA ABOU HASHEM ALI


Professor of Cardiology Faculty of Medicine Zagazig University

KAMAL SAAD MANSOUR


Lecturer of Cardiology Faculty of Medicine Zagazig University

SEHAM MAHROUS ZAKY


Lecturer of Clinical Pathology Faculty of Medicine Zagazig University

1993

SUMMARY AND CONCLUSIONS Cigarette smoking, hypertension and hypercholesterolemia are the most established coronary artery disease risk factors. Neutrophils constitute the front line assault force assigned to protect the host against the pyogenic microorganisms, they act as secretor for lysosomal enzymes and oxygen metabolites. Recently different studies have demonstrated that neutrophils play an important role in pathophysiology of myocardial ischemia and infarction. Neutrophil elastase and oxygen free radical have shown to destroy the integrity of the vascular endothelium, vascular basement membrane and subendothelial matrix. In the present study we asses the neutrophil functions using the methods of chemotaxis under agarose and nitroblue tetrazolium test among some of the coronary artery disease risk factors (cigarette smokers, hypertensive and hypercho-lesterolemic. Subjects of this study were classified into four groups: Group I : Comprised 10 healthy subjects. Group II : Comprised 10 cigarette smokers. The mean value of the number of smoked cigarette was 24 +. 11 cigarette per day and the duration of smoking was 8 + 5 years. Group III : Comprised 10 hypertensive subjects, The mean value of systolic, diastolic and mean blood pressure were 194 + 24, 126 + 20 and 149 + 20 mmHg respectively. Group IV : Comprised 10 hypercholesterolemic subjects. The mean value of the total blood cholesterol was 357 + 162 mg/dl. It was found that neutrophil chemotactic function as reflected by chemotactic index (C.I.) and chemotactic differential (CD.) and oxidation

reduction function as reflected by nitroblue tetrazolium (N.B.T.) test were significantly increased among cigarette smokers compared with control subjects (P<0.05). There was insignificant correlation between chemotactic function and nitroblue tetrazolium reduction function of neutrophils and the number of cigarette smoked per day and duration of smoking per year (P<0.05). This indicates that neutrophil activation occur early in the smoking habit, furthermore it is not dose dependant. It was found that neutrophil chemotactic function and nitroblue tetrazolium reduction function were insignificantly changed among the hypertensive subjects compared with control subjects (P>0.05). Also, it was found that neutrophil chemotactic function and nitroblue tetrazolium reeducation function were significantly increased among the hypercholesterolemic subjects compared with control subjects (P<0.05). There was a positive significant correlation between chemotactic function and nitroblue tetrazolium reduction function of neutrophils and total blood cholesterol level. Regardless the precise stimulus, enhanced neutrophil function in cigarette smokers and hypercholesterolemic subjects may be the end stage pathway in the pathophysiology of the development and progression of coronary artery disease. The increased functional potential of neutrophils may be a marker of increased risk of coronary artery disease. Finally, suppression of neutrophil function by drugs such as ibuprofen and nafazatron may has an important role in primary and secondary prevention of coronary artery disease.