RANKL and OPG Serum Levels in Acute Coronary Syndrome

Abstract

Background: Numerous inflammatory mediators seem to play a pathogenic role in coronary artery disease, promoting atherogenesis and plaque destabilization, leading to thrombus formation with development of this disease. The effects of the RANKL/OPG system, like modulation of cell survival and inflammation, make it an elect mediator in the progression of atherosclerotic lesions.

Objectives: To estimate the role of RANKL and OPG and their relative ratio (RANKL\OPG) in pathogenesis of acute coronary syndrome.

Subjects and Methods: Sixty patients with acute coronary syndrome were enrolled in this study, those patients were divided into two groups: 31 patients were with unstable angina (UA) and 29 patients were with myocardial infarction (MI), the latter group also subdivided into [18 with ST segment elevation myocardial infarction (STEMI) and 11 with non-ST-segment elevation myocardial infarction (NSTEMI)], their ages range from 25-83 years. Twenty apparently healthy volunteers their ages and sexes were matched with the patients were also participated in the study. ELISA was carried out for estimation the serum levels of RANKL and OPG in the studied groups.

Results: There was no significant difference (p>0.05) in median of serum levels of RANKL between patients and control. In addition the comparison among the three groups of patients (NSTEM1, STEM1 and UA) showed no significant differences (p>0.05) in RANKL level. Whereas the OPG level was significantly higher (p<0.001) in patients than that in healthy control, and there was significant increase in median serum level of OPG in the three patients groups as compared to control. On the other hand, there were no significant differences (p>0.05) in median serum levels of OPG among patients groups. The ratio of RANKL / OPG was significantly increase (P<0.001) in healthy control as compared to patients. The median of RANKL / OPG ratios in NSTEM1, STEM1 and UA patients groups were significantly lower (P<0.001) when compared to the ratio in healthy control. In contrast there were no significant differences in ratio among patients groups (p>0.05).

Conclusion: These findings indicated that there was high significant elevation in serum level of OPG in acute coronary syndrome, so, it enforce the clinical utility of OPG in atherosclerosis and suggested that RANKL/OPG ratio could be a biomarker for acute coronary syndrome.

Keywords: Acute coronary syndrome, RANKL, OPG.