Abstract
Inflammation and its genetic regulation play crucial roles in the development of unstable angina (UA), a key manifestation of coronary artery disease (CAD). However, the genetic determinants that influence cytokine production and interindividual inflammatory responses remain incompletely understood, particularly in the Chinese population. This study aimed to clarify the relationship between inflammatory cytokine gene polymorphisms, serum cytokine expression, and UA risk. A hospital-based case–control study was conducted in 160 patients with UA and 280 age- and sex-matched healthy controls. Participants meeting the 2007 ACC/AHA UA/NSTEMI diagnostic criteria and angiographic evidence of ≥ 50% coronary stenosis were included, while individuals with systemic inflammatory or metabolic disorders were excluded. Serum cytokine levels (IL-1β, IL-6, IL-10, IL-17, IFN-γ, TNF-α) were quantified by ELISA, and 13 cytokine gene loci were genotyped using PCR-RFLP. Associations between polymorphisms and UA were evaluated using multivariate logistic regression with odds ratios (ORs) and 95% confidence intervals (CIs). All cytokines were significantly elevated in UA patients compared with controls (p < 0.01), with IL-10 showing the largest increase (3.2-fold). Polymorphisms at seven loci were significantly associated with UA susceptibility: IL-1β − 511 C/T (TT vs. CC: OR = 6.39, 95% CI 2.94–13.87), TNF-α − 308 G/A (AA vs. GG: OR = 2.56, 95% CI 1.50–4.37), IL-6 − 1363 G/T (GT vs. GG: OR = 0.52, 95% CI 0.34–0.80), IL-10 − 1082 G/A and − 592 C/A, IL-17 rs2275913, and IFN-γ + 874 A/T (all p < 0.05). ROC analysis revealed strong discriminatory ability for IL-1β − 511 C/T (AUC = 0.87) and TNF-α − 308 G/A (AUC = 0.84), both with sensitivity and specificity > 80%. Moreover, carriers of risk alleles (e.g., IL-1β T, TNF-α A) exhibited higher cytokine levels, indicating functional upregulation of inflammatory activity. Cytokine gene polymorphisms, particularly IL-1β − 511 C/T and TNF-α − 308 G/A, are associated with heightened inflammatory responses and increased UA susceptibility. These variants may serve as potential genetic biomarkers for coronary instability, though further multicenter and functional validation is warranted before clinical application. Keywords: unstable angina; coronary artery disease; inflammatory cytokines; genetic polymorphism; biomarker; Enzyme-Linked Immunosorbent Assay; Polymerase Chain Reaction–Restriction Fragment Length Polymorphism.
Similar content being viewed by others
Data availability
De-identified datasets, including aggregated genotype frequencies and anonymized cytokine concentration data, are available from the corresponding author upon reasonable request for academic purposes, in compliance with institutional ethics approval.
References
Hof, D. & von Eckardstein, A. [Risk factors in atherosclerotic coronary heart disease]. Ther. Umsch. 66, 253–259 (2009).
Stephens, J. W., Bain, S. C. & Humphries, S. E. Gene-environment interaction and oxidative stress in cardiovascular disease. Atherosclerosis 200, 229–238 (2008).
Yamada, Y., Ichihara, S. & Nishida, T. Molecular genetics of myocardial infarction. Genomic Med. 2, 7–22 (2008).
Center For Cardiovascular Diseases The Writing Committee Of The Report On Cardiovascular Health And Diseases. China N. Report on cardiovascular health and diseases in China 2023: an updated summary. Biomed. Environ. Sci. 37, 949–992 (2024).
Nemer, M. Genetic insights into normal and abnormal heart development. Cardiovasc. Pathol. 17, 48–54 (2008).
Oksjoki, R., Kovanen, P. T. & Pentikainen, M. O. Role of complement activation in atherosclerosis. Curr. Opin. Lipidol. 14, 477–482 (2003).
Krishnan, E. Inflammation, oxidative stress and lipids: the risk triad for atherosclerosis in gout. Rheumatol. (Oxford). 49, 1229–1238 (2010).
Malinowski, D., Safranow, K. & Pawlik, A. TGF-beta1 and TGFbetaR2 gene polymorphisms in patients with unstable angina. Biomedicines 11, 155 (2023).
Bernard, V. et al. The – 308 G/A tumor necrosis factor-alpha gene dimorphism: a risk factor for unstable angina. Clin. Chem. Lab. Med. 41, 511–516 (2003).
Manginas, A. et al. Inflammatory cytokine gene variants in coronary artery disease patients in Greece. Coron. Artery Dis. 19, 575–582 (2008).
Laine, P. et al. Evidence for complement activation in ruptured coronary plaques in acute myocardial infarction. Am. J. Cardiol. 90, 404–408 (2002).
McNeill, E., Channon, K. M. & Greaves, D. R. Inflammatory cell recruitment in cardiovascular disease: murine models and potential clinical applications. Clin. Sci. (Lond). 118, 641–655 (2010).
Libby, P., Okamoto, Y., Rocha, V. Z. & Folco, E. Inflammation in atherosclerosis: transition from theory to practice. Circ. J. 74, 213–220 (2010).
Heslop, C. L., Frohlich, J. J. & Hill, J. S. Myeloperoxidase and C-reactive protein have combined utility for long-term prediction of cardiovascular mortality after coronary angiography. J. Am. Coll. Cardiol. 55, 1102–1109 (2010).
Zeno, S. A. et al. Cardiovascular fitness and risk factors of healthy African Americans and Caucasians. J. Natl. Med. Assoc. 102, 28–35 (2010).
Jia, X. et al. Association between the interleukin-6 gene – 572G/C and – 597G/A polymorphisms and coronary heart disease in the Han Chinese. Med. Sci. Monit. 16, CR103–108 (2010).
Fraser, A. et al. Interleukin-6 and incident coronary heart disease: results from the British women’s heart and health study. Atherosclerosis 202, 567–572 (2009).
Abdulfattah, S. Y. & Samawi, F. T. Estimating the role of single-nucleotide polymorphism (rs1800629)-308 G/A of TNF-alpha gene as genetic marker associated with angina pectoris in a sample of Iraqi patients. J. Genet. Eng. Biotechnol. 21, 2 (2023).
Jin, X., Yin, S., Zhang, Y. & Chen, X. Quantitative assessment of the association between IL-10 -592 A/C polymorphism and Kawasaki disease risk in Chinese population: evidence from a meta-analysis. Cardiol. Young. 28, 811–815 (2018).
Jin, X., Wu, Y., Yin, S., Chen, X. & Zhang, Y. Association between the IL-10 and IL-6 polymorphisms and brucellosis susceptibility: a meta-analysis. BMC Med. Genet. 21, 63 (2020).
Jin, X., Yin, S. & Zhang, Y. Association between the IL-10-1082G/A, IL-10-819T/C and IL-10-592A/C polymorphisms and brucellosis susceptibility: a meta-analysis. Epidemiol. Infect. 147, e316 (2019).
Jin, X., Yin, S., Zhang, Y. & Chen, X. Association between TLR2 + 2477G/A polymorphism and bacterial meningitis: a meta-analysis. Epidemiol. Infect. 146, 642–647 (2018).
Jin, X., Yin, S., Zhang, Y. & Chen, X. Association between TLR2 Arg677Trp polymorphism and tuberculosis susceptibility: A meta-analysis. Microb. Pathog. 144, 104173 (2020).
Chen, X. et al. XRCC3 C18067T polymorphism contributes a decreased risk to both basal cell carcinoma and squamous cell carcinoma: evidence from a meta-analysis. PLoS One. 9, e84195 (2014).
Qin, L. Y., Chen, X., Li, P., Yang, Z. & Mo, W. N. Association between the XRCC3 Thr241Met polymorphism and cervical cancer risk: a meta-analysis. Asian Pac. J. Cancer Prev. 14, 6703–6707 (2014).
Wang, Z. et al. Quantitative assessment of the associations between DNA repair gene XRCC3 Thr241Met polymorphism and gastric cancer. Tumour Biol. 35, 1589–1598 (2014).
Yan, Y., Chen, X., Li, T., Li, M. & Liang, H. Association of OGG1 Ser326Cys polymorphism and pancreatic cancer susceptibility: evidence from a meta-analysis. Tumour Biol. 35, 2397–2402 (2014).
Chen, X. et al. Association of GSTP1 -313A/G polymorphisms and endometriosis risk: a meta-analysis of case-control studies. Eur. J. Obstet. Gynecol. Reprod. Biol. 171, 362–367 (2013).
Chen, X., Mo, W., Peng, Q. & Su, X. Lack of association between Fas rs180082 polymorphism and risk of cervical cancer: an update by meta-analysis. BMC Med. Genet. 14, 71 (2013).
Si, D., Yao, Y., Chen, X. & Qiu, J. Ethnicity-stratified analysis of the association between P53 rs1042522 polymorphism and women HPV infection: A meta-analysis. Microb. Pathog. 161, 105099 (2021).
Chen, X., Li, P., Yang, Z. & Mo, W. N. Expression of fragile histidine triad (FHIT) and WW-domain oxidoreductase gene (WWOX) in nasopharyngeal carcinoma. Asian Pac. J. Cancer Prev. 14, 165–171 (2013).
Chen, X. et al. Genetic polymorphism of IL-18 influences susceptibility to lung cancer in population of Eastern China. J. Cancer. 15, 4604–4611 (2024).
Yuanyuan, G., Xue, Y., Yachao, L., Xiao, F. & Xu, C. Association between IL-18 -607 C/A polymorphism and the risk of prostate cancer: A Meta-Analysis of Case-Control studies. Asian Pac. J. Cancer Prev. 20, 1595–1602 (2019).
Chen, X. et al. Expression of miR-192-5p in colon cancer serum and its relationship with clinicopathologic features. Am. J. Transl Res. 13, 9371–9376 (2021).
Chen, X., Xu, J., Zhu, Q., Ren, Y. & Zhao, L. Polymyxin B resistance rates in carbapenem-resistant Pseudomonas aeruginosa isolates and a comparison between Etest((R)) and broth microdilution methods of antimicrobial susceptibility testing. Exp. Ther. Med. 20, 762–769 (2020).
Niu, K., Chen, X. & Lu, Y. COL3A1 rs1800255 polymorphism is associated with pelvic organ prolapse susceptibility in Caucasian individuals: evidence from a meta-analysis. PLoS One. 16, e0250943 (2021).
Acknowledgements
The authors thank the staff of the Department of Cardiovascular Medicine, Deyang People’s Hospital, for technical assistance and patient recruitment. We also appreciate the contributions of postgraduate students from Southwest Medical University for data collection and sample processing.
Author information
Authors and Affiliations
Contributions
Qiulan Yang and Runfeng Zhang conceived study design and content concept; Jie Lou and QianZhen Huang performed the data collection, extraction and analyzed the data; Jie Lou and QianZhen Huang were responsible for literature search; Qiulan Yang and Runfeng Zhang interpreted and reviewed the data and drafts.
Corresponding authors
Ethics declarations
Competing interests
The authors declare no competing interests.
Ethics approval
This study was conducted with approval from the Ethics Committee of Taicang TCM hospital. This study was conducted in accordance with the declaration of Helsinki. Written informed consent was obtained from all participants.
Consent for publication
Written informed consent was obtained from all participants.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
About this article
Cite this article
Lou, J., Huang, Q., Zhan, R. et al. The effect of inflammatory factors on unstable angina risk, from the gene level. Sci Rep (2026). https://doi.org/10.1038/s41598-026-37963-4
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41598-026-37963-4


