INFLUENCE OF VARIOUS SURGICAL INTERVENTIONS ON VASCULAR WALL APOPTOSIS INDICES IN PATIENTS WITH ATHEROSCLEROSIS OF PERIPHERAL ARTERIES

Abstract

Objective. Assessment of apoptosis proteins Bcl-2 and Bax indices before and after the open vascular reconstructions and X-ray endovascular interventions in patients with the peripheral atherosclerosis of the arteries of the lower extremities. Methods. The study included patients (n=40) with the peripheral atherosclerosis of the lower extremities arteries (stage III-IV) disease who underwent open surgery - group A, and patients (n=40) who underwent endovascular interventions - group B. Two apoptosis proteins were analyzed in blood serum: Bax and Bcl-2 initially before surgery, on the 1st day and after 1 month. The reference values of the studied parameters were determined in 40 healthy volunteers. Results. Initial Bax protein index - 27.1 ng / ml (р<0,001) were elevated in patients of group A and reduced Bax protein - 4.4 ng / ml (p=0.00008) in patients of group B compared with indices of healthy volunteers (16.5 ng / ml, 5.3 ng / ml, respectively). On the 1st day after the interventions in the patients of the operative groups there was an increasing tendency for Bax index to 35.6 ng / ml (p<0.001) - group A, to 25.6 ng/ml (p<0.001) - group B. By the end of 1st month, Bax was increased to 28 ng/ml (p<0.001) in patients of group A and Bcl-2 was reduced to 3.0 ng / ml (p=0.039) compared to the initial indices; in patients of group B, only protein Bax - 23.9 ng / ml (p<0.001) was increased. Conclusion. Open and endovascular intervention on the arteries of the lower extremities leads to the activation of the pro-apoptotic protein Bax on the 1st day after surgery. In the postoperative period the open reconstruction leads to an evaluation of the pro-apoptotic potential in comparison with endovascular intervention in the form of increasing Bax protein and reducing Bcl-2 by the end of the first month. What this paper adds The dynamics of changes markers Bcl-2 and Bax in apoptosis at different periods after surgery has been firstly studied in patients with atherosclerosis of peripheral arteries (stage III-IV) of the lower extremities. It has been found that the open surgery leads to a sufficient evaluation of the proapoptotic potential, i.e. the increasing Bax protein index on the 1st day and by the end of 1st month with reducing Bcl-2 index by the end of 1st month compared with the endovascular intervention.