Systemic endotoxinemia as a risk factor for atherosclerosis of extracranial brachiocephalic arteries

Abstract

Risk factors (RFs) for development of atherosclerosis are numerous, exceeding 200 based on different approaches to studying atherogenesis. The concept of inflammation is the prevailing idea, which focuses on changes in the arterial wall. This concept has developed into the endotoxin theory of atherosclerosis and was supported by multiple experimental studies and clinical observations. However, existing scales for assessing the cardiovascular risk produce a maximum error for patients with an intermediate cardiovascular risk. This leads to unnecessary diagnostic procedures or underestimation of risk. Therefore, searching for new risk factors of preclinical atherosclerosis is relevant and was an objective of this study.
Methods. The study included 104 people of the same risk group (less than 1-4% on the SCORE scale). The subjects had no complaints at the time of the study and considered themselves healthy. We evaluated indexes, which could be considered RFs and applicable in practice, including plasma level of endotoxin and serum concentrations of antibodies to hydrophobic and hydrophilic parts of the lipopolysaccharide (AB-LPS) molecule.
Results. Significant differences between concentrations and incidence rates of the studied indexes were found in patients with different severity of atherosclerotic lesions in the carotid arteries. At the same time, there were no differences in lipid profiles. A follow-up of subjects who had no significant changes in their lifestyle in 1.5 years showed that the subjects with improved vascular wall structure differed from the others only in parameters of systemic endotoxinemia.

Conclusion. Inclusion of such indexes as concentrations of endotoxin and AB-LPS, can help predicting the condition of carotid wall and, thus, modifying the risk in patients at the level of primary diagnosis without involvement of high-tech, expensive imaging techniques.