Effect of clinically uneventful carotid endarterectomy on pentraxin 3 concentration: relationships between cognitive functions, local inflammation, and duration of brain ischemia.

Abstract

Introduction: The pentraxins are a superfamily of proteins characterized by the presence of a pentraxin domain at the C-terminal. One of them is pentraxin 3 (PTX3), which is of great interest to scientists, primarily due to its function as an endogenous modulator of the inflammatory response. Local inflammation is a common phenomenon during various types of surgery and procedures, and its causes, among others, are local ischemia or tissue irritation. One such procedure is carotid plaque removal by carotid endarterectomy (CEA), which is performed to reduce the risk of stroke.

Material and methods: The purpose of this study was to investigate the effect of CEA on PTX3 concentration and the relationship between cognitive functions and the duration of brain ischemia in patients. We evaluated the relationships using blood collected from patients undergoing CEA, the Mini-Mental State Examination (MMSE) questionnaire, and commercially available ELISA tests.

Results: Results: We found that the concentration of PTX3 increased after surgery (from 0.59 ± 0.11 to 1.29 ± 0.29 ng mL^-1; P < 0.01). Also, a decrease in the MMSE score was observed 24 hours after the procedure (P < 0.01). However, just one month after the procedure, it significantly increased compared to the day of admission to the hospital (P < 0.01). Our results did not demonstrate any interactions between the tested parameters. It can be concluded that neither the changes in PTX3 concentration following the procedure nor the timing of these changes directly contribute to the temporary deterioration of cognitive functions observed after CEA.

Conclusions: PTX3 increases independently of the duration of cerebral hypoxemia/ hypercapnia after clamping the carotid artery. This rise is an inflammatory marker that occurs independently within the central nervous system.