Association between lectin complement pathway initiators, C-reactive protein and left ventricular remodeling in myocardial infarction-a magnetic resonance study

Mikkel Malby Schoos, Lea Munthe-Fog, Mikkel-Ole Skjoedt, Rasmus Sejersten Ripa, Jacob Lønborg, Jens Kastrup, Henning Kelbæk, Peter Clemmensen, Peter Garred

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Abstract

Lectin complement pathway (LP) activation is an important mechanism in myocardial ischemia reperfusion injury (IRI). LP is activated via the recognition molecules mannose-binding lectin (MBL), ficolins-2 and-3 and is regulated by MBL/Ficolin-associated Protein-1 (MAP-1). Also, C-reactive protein (CRP) and ficolin-2 interact in vitro, but the role of the ficolins in IRI is unknown.Methods and results
In 55 patients with ST segment elevation myocardial infarction, we investigated the association of LP components and CRP in plasma samples with left ventricular (LV) end systolic and diastolic volumes (ESV and EDV) and infarct size, assessed by cardiac magnetic resonance early at 1–3 days after primary percutaneous coronary intervention and at 6 months follow-up. Opposed to MBL, ficolin-3 and MAP-1, ficolin-2 levels were low at baseline. At baseline, ficolin-2 > median was associated with ESV and EDV increases by 7.83 ml/m2 (p = 0.004) and 14.04 ml/m2 (p < 0.001). MBL and MAP-1 were not associated with LV dilatation, yet ficolin-2 and MBL worked synergistically and the combination of their levels > median was associated with ESV (11.21 ml/m2; p = 0.017) and EDV increases (14.72 ml/m2; p = 0.006). MAP-1 < median + ficolin-2 > median had the greatest LV dilatation (17.61 ml/m2). The ficolin-2 × CRP interaction variable was positively associated with infarct size and inversely associated with EDV change over 6 months (p = 0.006). There was no interaction between CRP and the other LP molecules.
Conclusion
The LP initiator molecule ficolin-2 and combinations of ficolin-2, MBL and MAP-1 are associated with LV dilatation after myocardial infarction. Interaction of ficolin-2 and CRP was associated with infarct size and LV remodeling, indicating a potential role for LP and LP-pentraxin cross-activation in IRI and LV remodeling.
OriginalsprogEngelsk
TidsskriftMolecular Immunology
Vol/bind54
Udgave nummer3-4
Sider (fra-til)408-14
Antal sider7
ISSN0161-5890
DOI
StatusUdgivet - jul. 2013

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