Miażdżyca tętnic szyjnych a otępienie – czynniki zapalne i wskaźnik aktywacji makrofagów

Purpose
To assess the relationship between serum inflammatory markers (interleukin 6, high sensitivity C-reactive protein [hsCRP] and chitotriosidase activity) and the extent of carotid atherosclerotic lesions in subjects with various types of dementia.

Methods
Four hundreds persons with dementia (166 diagnosed as probable Alzheimer’s disease, 85 as vascular dementia [VaD], 149 as mixed dementia [MD] and 180 controls) were observed. In all persons carotid intima-media thickness (IMT) was measured and all were subjected to a general medical and neurological evaluation, neuroimaging examination (computed tomography and magnetic resonance) and comprehensive neuropsychological examination. The pro-inflammatory markers interleukin-6 (IL-6) and hsCRP, and anti-inflammatory markers (paraoxonase-1 activity and HDL cholesterol level), were determined in blood serum. Chitotriosidase activity – an indicator of chronic macrophage activation – was also determined.

Results
A higher frequency of carotid atherosclerosis was observed in the whole group of dementia and in the VaD and MD groups as compared to the controls. A significant positive correlation of IMT with the inflammatory indicators IL-6 and hsCRP was found. A negative correlation of IMT with inflammatory markers (paraoxonase-1 activity and HDL cholesterol level) was observed. Chitotriosidase activity was significantly elevated, as compared with the controls, in the whole group with dementia and in the MD group, and depended on the degree of carotid stenosis.

Conclusions
Serum IL-6, hsCRP and chitotriosidase activity can be considered as markers of the extent of carotid arteriosclerosis in dementia, especially in patients with dementia with vascular lesions. High chitotriosidase activity may indicate chronic macrophage activation in the course of dementia development.