Key result
Chronic coronary syndrome patients exhibit elevated basal and exercise-induced NLRP3 inflammasome expression up to 6 months post-event.
Why the study?
Increased expression of NLRP3 inflammasome components occurs in acute coronary syndrome, but whether this persists beyond the acute phase into chronic coronary syndrome was less known.
Are basal and exercise-induced NLRP3 inflammasome components elevated in patients with chronic coronary syndrome compared to controls?
Observational (n=111)
Are basal and exercise-induced NLRP3 inflammasome components elevated in patients with chronic coronary syndrome compared to controls?
Patients with chronic coronary syndrome maintain a primed NLRP3 inflammasome system up to 6 months post-event, which is further pronounced after acute exercise, suggesting persistent inflammation despite clinical stability.
Suggests residual inflammatory risk in stable CCS; leaves open NLRP3-targeted intervention trials.
BACKGROUND AND AIMS: NLRP3 inflammasome is considered a critical actor in the inflammatory process of coronary artery disease. Increased expression of NLRP3 inflammasome components has been reported in patients with acute coronary syndrome, but whether this persists beyond the acute phase is less known. We performed a prospective study to investigate whether basal and/or exercise-induced NLRP3 inflammasome components were elevated in patients with chronic coronary syndrome (CCS). METHODS: Patients (n = 81) underwent exercise stress tests twice: 3-4 weeks and 3-6 months after a major coronary event, whereas controls (n = 30) performed it once. Concentrations of interleukin(IL)-18, IL-1Ra and IL-6 were measured before and 30 min after exercise. Genes related to NLRP3 inflammasome and NFκB signaling pathways were measured in blood mononuclear cells before and after exercise. On the first visit, patients were prescribed an exercise-based cardiac rehabilitation program. Physical activity levels were reported on both visits. RESULTS: Patients were clinically stable and exhibited increased exercise capacity as well as increased self-reported physical activity between visits. Basal plasma levels of IL-18, as well as exercise-induced levels of IL-18 and IL-1Ra, were higher in patients compared with controls on both visits. Also, basal gene expression of NLRP3 was higher in patients, as were several NFκB-related genes. After exercise, gene expression related to NLRP3 inflammasome activation, in particular P2RX7, was higher in patients on both visits. CONCLUSIONS: Up to 6 months after a coronary event, patients exhibited an increase in NLRP3 inflammasome-related components that was even more pronounced after acute exercise, compared with controls. The results indicate that a primed NLRP3 inflammasome system is maintained despite clinical stability and best available therapy, highlighting the need to further combat inflammation in patients with CCS.
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Mahmood et al. (2025) conducted an observational in Chronic coronary syndrome (n=111). Exercise stress test vs. Controls was evaluated on Basal and exercise-induced expression of NLRP3 inflammasome-related components (IL-18, IL-1Ra, IL-6, and related genes). Up to 6 months after a coronary event, patients with chronic coronary syndrome exhibited increased basal and exercise-induced expression of NLRP3 inflammasome-related components compared with controls.
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