A Reliable Marker of Endothelial Cell Dysfunction and Vascular Damage: Legend or Reality?

Abstract

Listen

Translate article

Abstract Endothelial dysfunction is considered to be a pre-clinical stage of atherosclerosis and represents an initial step of plaque progression. The aim of this study is to investigate whether the overproduction of biochemical markers is related to vascular damage. We studied 72 patients split into three groups: 20 patients had no vessels significant disease; 18 patients had multi-vessels disease; 34 patients had multi-vessels disease and stenosis >50%. Patients with known coronary artery disease, stroke, hypertension, diabetes and/or dyslipidemia were excluded from the study. We measured plasma levels of vWF (a marker of endothelial stress), VEGF (a marker of neointimal proliferation), TF and E-selectin (a marker of endothelial activation), all were measured by ELISA, and we investigated if their increased levels are related to the endothelial damage (table 1). Table 1. No disease Multi vessels Multi vessels disease+stenosis vWF (IU/dl) 84–102 128–154 146–182 VEGF (pg/ml) 28–124 120–180 160–240 TF (pg/ml) 16–98 80–220 230–370 E-Selectin (ng/ml) 30–74 72–96 94–128 There is a significant relation between vWF, VEGF, TF and E-Selectin and vessels disease severity; patients with no vessels disease had an average thickness of 0.48 mm, (IMT: 0.6–1.18mm), patients with multi vessels disease had a median atheroma score of 1.12, (IMT:1.18–2.42mm), patients with multi vessels disease and stenosis had a mediam atheroma score of 2.40, (IMT:>2.42mm), indeed we did not find any significant relation between increased arterial stiffness and laminar shear-stress. Healthy endothelium exerts a favourable and athero-protective effects by a numbers of factors. Table 2. Favorable and Atheroprotective Effects of the Healthy Endothelium Promotion of vasodilation Antioxidant effects Anti-inflammatory effects Inhibition of leukocyte adhesion and migration Inhibition of smooth muscle cell proliferation and migration Inhibition of platelet aggregation and adhesion Anticoagulant effects Profibrinolytic effects Table 3. Risk factors and predictors of endothelium dysfunction Recruiment of inflammatory cells SMC proliferation Neointimal formation Oxidative stress Activation of procoagulant activities Activation of plateolet adhesion and aggregation Stasis of blood flow In conclusion, we demonstrated that high levels of vWF, VEGF, TF, E-Selectin may play a critical role as for the development and the progression of atherosclerosis, even if further and wider studies are needed to confirm this statement.