Assessment of endothelial damage in atherosclerotic vascular disease by quantification of circulating endothelial cells - Relationship with von Willebrand factor and tissue factor
Assessment of endothelial damage in atherosclerotic vascular disease by quantification of circulating endothelial cells - Relationship with von Willebrand factor and tissue factor
复制标题
DOI：
10.1016/j.ehj.2003.04.001
复制
发表时间：
2004-03-01
影响因子：
39.3
通讯作者：
Lip, GYH
中科院分区：
文献类型：
--
作者：
Makin, AJ;Blann, AD;Lip, GYH
急性冠状动脉综合征患者外周血中CD 146定义的循环内皮细胞（CEC）数量增加，意味着内皮损伤。内皮损伤也可以通过测量血管性血友病因子（vWf）的血浆水平来评估。动脉粥样硬化中存在单核细胞/巨噬细胞和内皮细胞产生的促凝血血浆组织因子（TF）水平升高。我们假设，与间歇性跛行（IC）患者或与vWf和TF相关的健康对照相比，由于外周动脉粥样硬化引起的下肢缺血性静息痛（IRP）患者的CEC增加，与急性心肌梗死（AMI）患者的CEC增加相当。（二）急性心肌梗死;（iii）“稳定的”IC;和（iv）健康对照。结果IRP患者CEC中位数（IQR）为3.5（2.0-5.8）cells/ml，IC患者CEC中位数（IQR）为1.1（0.6-2.9）cells/ml，而健康对照组CEC中位数（IQR）为1.0（0.5-1.7）cells/ml（P < 0.001）。vWf（p = 0.034）和TF（p = 0.007）水平在两组之间也存在显著差异，IRP患者的水平最高。CEC水平与vWf（r（s）= 0.4，p = 0.002）和TF（r（s）= 0.296，p = 0.021）相关。AMI患者CEC水平高于IRP患者，为4.9（3.6-8.4）cells/ml（p = 0.0385）。结论IRP患者CEC水平升高，与vWf和TF相关，但较AMI患者轻。(C)2004年由Elsevier Ltd代表欧洲心脏病学会出版。
Background Increased numbers of CD146-defined circulating endothelial cells (CECs), as are present in the peripheral blood of patients suffering acute coronary syndromes, imply injury to the endothelium. Endothelial damage can also be assessed by the measurement of plasma levels of von Willebrand factor (vWf). Increased levels of procoagulant plasma tissue factor (TF), arising from monocytes/macrophages and endothelial cells, is present in atherosclerosis. We hypothesised increased CECs in patients with ischaemic rest pain (IRP) of the lower limb due to peripheral atherosclerosis and comparable to that seen in patients with acute myocardial infarction (AMI), when compared to patients with intermittent claudication (IC) or healthy controls that would correlate with vWf and TF.Patients and methods We recruited 20 patients in each of four groups: (i) IRP of the lower limb; (ii) AMI; (iii) 'stable' IC; and (iv) healthy controls. CD146-expressing CECs were measured by immumomagnetic separation and counting under a fluorescence microscope; plasma vWf and TF by ELISA.Results In IRP, median (IQR) CEC levels were 3.5 (2.0-5.8) cells/ml, in IC were 1.1 (0.6-2.9) cells/ml, and in healthy controls were 1.0 (0.5-1.7) cells/ml (p < 0.001). The levels of vWf (p = 0.034) and TF (p = 0.007) were also significantly different between the groups, with the highest levels in patients with IRP. Levels of CECs correlated with vWf (r(s) = 0.4, p = 0.002) and TF (r(s) = 0.296, p = 0.021). In AMI, CEC levels were higher than those in IRP at 4.9 (3.6-8.4) cells/ml (p = 0.0385).Conclusion This study demonstrates evidence of direct endothelial cell injury (i.e. raised CECs) in patients with IRP that correlated with vWf and TF, but that this is less severe than in AMI. (C) 2004 Published by Elsevier Ltd on behalf of The European Society of Cardiology.