Carotid artery stenosis (CS) is a well-established risk factor for
stroke. Increased proinflammatory
chemokines, enhanced
metallothionein (MT), and altered
metal homeostasis may play roles in
atherosclerosis progression and plaque destabilization. MT may sequester
zinc during chronic
inflammation, provoke
zinc deficiency, and modulate NK cell cytotoxicity. A recent investigation of older patients with diabetes and
atherosclerosis showed an association between the -209 A/G MT2A polymorphism, CS, and
zinc status. In this study, we evaluated the relationship between two MT2A polymorphisms (-209 and + 838 locus),
metal status, and inflammatory/immune response in older patients with CS only (the CS1 group) or with CS and previous cerebrovascular episodes (
transient ischemic attack or
stroke) (the CS2 group). A total of 506 individuals (188 CS1, 100 CS2, and 218 healthy controls) were studied. Atherosclerotic patients (CS1 and CS2) showed increased levels of MT, MCP-1, and
RANTES, reduced NK cell cytotoxicity, and altered
trace element concentrations (
zinc,
copper,
magnesium,
iron). The +838 C/G MT2A polymorphism was differently distributed in CS1 and CS2 patients, who displayed the GG genotype (C-) with significantly higher frequency than elderly controls. C- carriers showed increased MCP-1 and decreased NK cell cytotoxicity, CD56+ cells, and intracellular
zinc availability along with decreased
zinc,
copper, and
magnesium content in erythrocytes and increased
iron in plasma. C- carriers also showed a major incidence of soft carotid plaques. In conclusion, the +838 C/G MT2A polymorphism seems to influence inflammatory markers,
zinc availability, NK cell cytotoxicity, and
trace element status, all of which may promote CS development.