Argyrophilic Nucleolar Organizer Regions as New Biomarkers in ST-Elevation Myocardial Infarction

Abstract

(1) Background: ST-elevation myocardial infarction (STEMI) is an inflammatory disease in which neutrophils, macrophages, and lymphocytes accumulate in the ischemic myocardium and have important functions. Nucleolar-organizing regions (NORs) are the site of the ribosomal genes composed of ribosomal DNA and proteins. We aimed to evaluate AgNOR proteins, which have never been studied in patients with STEMI in the literature. (2) Methods: A total of 140 participants (75 with STEMI and 65 volunteers without any diagnosis of acute coronary syndrome) were included in this study. Echocardiography was carried out, and mean AgNOR number and total AgNOR area/total nuclear area (TAA/TNA) were evaluated for all individuals. (3) Results: The mean AgNOR number and TAA/TNA ratio were significantly higher in the STEMI group than the control (p < 0.001). Statistically significant relations between both TAA/TNA ratio and mean AgNOR number and interventricular septal thickness, fasting blood sugar, creatinine, HDL, hemoglobin (g/dL), WBC (µL/mL), monocytes, neutrophils, and neutrophil/lymphocyte ratio were detected (p < 0.05). Moreover, a statistically significant relation between LDL (mg/dL) and mean AgNOR number (p = 0.005) was detected. (4) Conclusion: Both AgNOR protein amounts increase depending on the hypoxia that occurs in STEMI. The AgNOR proteins may thus be promising markers in STEMI.

Keywords: AgNOR; STEMI; hypoxia; ischemia.

Figure 1

Silver-stained NORs in the lymphocytes of STEMI (a–d) and control (e–h) group members (×100 magnification).

Figure 2

The relation between fasting blood sugar and TAA/TNA ratio (a), creatinine and TAA/TNA ratio (b), hemoglobin and TAA/TNA ratio (c), HDL and TAA/TNA ratio (d), WBCs and TAA/TNA ratio (e), monocytes and TAA/TNA ratio (f), neutrophils and TAA/TNA ratio (g), neutrophil/lymphocyte ratio and TAA/TNA ratio (h), IVST and TAA/TNA ratio (i), and EF and TAA/TNA ratio (j) for both groups.

Figure 3

The relation between fasting blood sugar and the mean AgNOR number (a), creatinine and the mean AgNOR number (b), LDL and the mean AgNOR number (c), HDL and the mean AgNOR number (d), hemoglobin and the mean AgNOR number (e), WBCs and the mean AgNOR number (f), monocytes and the mean AgNOR number (g), neutrophils and the mean AgNOR number (h), neutrophil/lymphocyte ratio and the mean AgNOR number (i), and IVST and the mean AgNOR number (j) for both groups.