Circulating endothelial microparticles in acute ischemic stroke: a link to severity, lesion volume and outcome
Circulating endothelial microparticles in acute ischemic stroke: a link to severity, lesion volume and outcome
复制标题
DOI：
10.1111/j.1538-7836.2006.01911.x
复制
发表时间：
2006-06-01
影响因子：
10.4
通讯作者：
Baird, A. E. .
中科院分区：
文献类型：
--
作者：
Simak, J. .;Gelderman, M. P.;Baird, A. E. .
背景：血浆中内皮细胞膜微粒（EMP）在几种血管疾病中升高。目的：验证急性缺血性脑卒中患者EMP升高，并与卒中严重程度、脑损伤体积和预后相关的假设。患者和方法：41例患者根据美国国立卫生研究院卒中量表（NIHSS）评分分为两组：20例轻度卒中（NIHSS评分< 5分）和21例中重度卒中（NIHSS评分≥ 5分）。使用弥散加权磁共振成像测量病灶体积，出院结局基于出院Barthel和兰金评分。还研究了23名年龄匹配的对照受试者。使用流式细胞术，内皮糖蛋白阳性EMP：CD 105（+）CD 41 a（-）CD 45（-）（E+EMP），表达VE-钙粘蛋白和内皮糖蛋白的特异性内皮EMP：CD 105（+）CD 144（+）（C+EMP），表达磷脂酰丝氨酸的EMP：CD 105（+）PS（+）CD 41 a（-）（PS+EMP）和表达ICAM-1的EMP：分析CD 105（+）CD 54（+）CD 45（-）（I+EMP）。结果如下：在急性缺血性卒中患者组中观察到的PS+EMP计数[中位数59（第25 - 75百分位数：28-86）MP mu L-1]显著高于对照组[28（14-36）MP mu L-1]（P = 0.002）。中重度脑卒中组EMP四种表型均高于对照组（P均< 0.05）。在急性缺血性脑卒中患者中，EMP的三种表型（E+EMP、PS+EMP和I+EMP）与脑损伤体积显著相关，其中I+EMP（P = 0.002）显示出最强的相关性。C+EMP（P = 0.0003）和E+EMP（P = 0.003）的入院计数与出院临床结局显著相关。结论：某些循环EMP表型可能与急性缺血性卒中的严重程度、病变体积和预后相关。EMP分析显示了对理解中风病理生理学的有希望的贡献。
Background: Endothelial membrane microparticles (EMP) in plasma are elevated in several vascular diseases. Objectives: To test the hypothesis that EMP would be increased in patients with acute ischemic stroke and would correlate with stroke severity, brain lesion volume and outcome. Patients and methods: Forty-one patients were studied and divided into two groups based on the National Institutes of Health Stroke Scale (NIHSS) score: 20 patients with mild stroke (NIHSS score < 5) and 21 patients with moderate-severe stroke (NIHSS score >= 5). Lesion volume was measured using diffusion-weighted magnetic resonance imaging and discharge outcome was based on the discharge Barthel and Rankin scores. Twenty-three age-matched control subjects were also studied. Using flow cytometry, endoglin-positive EMP: CD105(+) CD41a(-)CD45(-) (E+EMP), specific endothelial EMP expressing VE-cadherin and endoglin: CD105(+)CD144(+) (C+EMP), EMP expressing phosphatidylserine: CD105(+)PS(+) CD41a(-) (PS+EMP) and EMP expressing ICAM-1: CD105(+)CD54(+) CD45(-) (I+EMP) were analyzed. Results: Significantly higher PS+EMP counts were observed in the group of acute ischemic stroke patients [median 59 (25th-75th percentile: 28-86) MP mu L-1] relative to the controls [28 (14-36) MP mu L-1] (P = 0.002). All four EMP phenotypes studied were elevated in the subgroup of moderate-severe stroke patients relative to the controls (all P < 0.05). In the patients with acute ischemic stroke three EMP phenotypes (E+EMP, PS+EMP and I+EMP) correlated significantly with brain lesion volume, with I+EMP (P = 0.002) showing the strongest correlation. Admission counts of C+EMP (P = 0.0003) and E+EMP (P = 0.003) correlated significantly with discharge clinical outcome. Conclusions: Certain circulating EMP phenotypes may be associated with severity, lesion volume and outcome of acute ischemic stroke. EMP analysis shows promising contribution to understanding stroke pathophysiology.