In vivo shear stress determines circulating levels of endothelial microparticles in end-stage renal disease
In vivo shear stress determines circulating levels of endothelial microparticles in end-stage renal disease
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DOI：
10.1161/01.hyp.0000259667.22309.df
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发表时间：
2007-04-01
期刊：
影响因子：
8.3
通讯作者：
London, Gerard M.
中科院分区：
文献类型：
--
作者：
Boulanger, Chantal M.;Amabile, Nicolas;London, Gerard M.
切应力是内皮细胞凋亡的主要决定因素，但其在内皮细胞体内释放脱落膜微粒中的作用仍不清楚。因此，我们试图评估具有高心血管风险的终末期肾病患者的循环内皮微粒水平和层流切应力之间的可能关系，这些患者的内皮微粒水平升高。在34例血液透析患者中，我们分析了肱动脉和主动脉切应力与循环微粒水平的关系。只有内皮微粒与层流剪切应力值（P < 0.0001）或其组分剪切速率和全血粘度呈负相关，与年龄或动脉血压无关。血液透析诱导的血液浓缩或促红细胞生成素贫血改善引起的红细胞压积变化诱导全血粘度和剪切应力显著增加，并与内皮微粒显著减少相关，与红细胞压积/血红蛋白或层流剪切应力的变化呈显著负相关。这些结果表明，在终末期肾病患者中，层流剪切应力是内皮微粒血浆水平的重要决定因素。贫血作为全血粘度和切应力的重要决定因素，有助于内皮细胞凋亡，并可能在这一高危人群的动脉硬化加速的发病机制中发挥间接作用。
Shear stress is a major determinant of endothelial apoptosis, but its role in the in vivo release of shed membrane microparticles by endothelial cells remains unknown. Thus, we sought to evaluate the possible relationship between circulating endothelial microparticle levels and laminar shear stress in end-stage renal disease patients with high cardiovascular risk, whose levels of endothelial microparticles are elevated. In 34 hemodialyzed patients, we analyzed the relationships between brachial artery and aortic shear stress and circulating microparticles levels. Only endothelial microparticles were inversely correlated with laminar shear stress values (P < 0.0001) or its components shear rate and whole blood viscosity, independent of age or arterial blood pressure. Changes in hematocrit resulting from hemodialysis-induced hemoconcentration or erythropoietin anemia improvement induced a significant increase in whole blood viscosity and shear stress and were associated with a significant decrease in endothelial microparticles with a significant and inverse correlation with changes in hematocrit/hemoglobin or laminar shear stress. These results demonstrate that, in end-stage renal disease patients, laminar shear stress is an important determinant of plasma levels of endothelial microparticles. Anemia as an important determinant of whole blood viscosity and shear stress, contributes to endothelial apoptosis, and could play an indirect role in the pathogenesis of accelerated arteriosclerosis in this high-risk population.