Jose Antonio Franchini Ramires
University of São Paulo Medical School, Brazil
Title: Inflammation, coronary artery disease and liver: what is the relationship?
Biography
Biography: Jose Antonio Franchini Ramires
Abstract
The liver is recognized as a metabolically active organ, responsible for the synthesis of protein, cholesterol and large glycogen storage. Moreover, when stimulated by cytokines released by any inflammatory process, produces and releases proteins into the circulation in response to inflammation, eg fibrinogen, serum amyloid A, C-reactive protein and others. But, while these proteins show the intensity of the inflammatory process they also should serve as a protective response. However, increased fibrinogen may predispose to thrombosis and the pentameric CRP synthesized by the liver becomes monomeric as it is involved in the local inflammation, there becomes the aggressor. With this, we conclude that the liver integrity is important for defending the body, producing inflammation markers and eventually determining aggression. If this reasoning is correct in severe liver disease we would lose the protection, without production of inflammatory response proteins. However, when we compare the presence and characteristic of atherosclerotic plaques of coronary arteries, in four groups of patients: 1-coronary artery disease, 2-liver pre-transplantation, 3-patients with other diseases (non-cardiac or liver) and 4-post-accident or gun, evaluated by necropsy, it was observed that the plaques have different content and different inflammatory response. The most interesting was the finding of the plaque of the row of transplant patients, having the lower cholesterol content, many fibrosis and, practically, absence of intraplaque bacterial agents or hemorrhage. So the question is: several liver failure is a protector of atherosclerosis ?