Abstract
Background: Sphingosine-1-phosphate (S1P) plays a significant role in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).Methods: We collected the plasma samples from 40 patients with AAV and 10 healthy volunteers. The plasma levels of S1P were tested by enzyme-linked immunosorbent assay (ELISA). The levels of serum creatinine (Scr) were tested by rate method, and then the estimated glomerular filtration rate (eGFR) of the patients was calculated from the Scr, age, and gender. Prothrombin time (PT), partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), fibrinogen reduction product (FDP), D-dimer and C-reactive protein (CRP) were tested by turbidimetric inhibition immunoassays. Platelets (PLTs) were tested by fluorescently labeled electrical impedance method.Results: The plasma levels of S1P were significantly higher in AAV patients than in healthy volunteers. Correlation analysis showed that plasma levels of S1P were negatively correlated with glomerular filtration (P=0.022, r = −0.306), and positively correlated with circulating levels of Birmingham vasculitis activity score (BVAS), PLT and D-dimer, (P=0.004, r = 0.443; P<0.001, r = 0.654; P=0.006, r = 0.427). The 40 patients with AAV were classified into three groups: the thromboembolism group (with complications of cerebral infarction and myocardial infarction, n=6), cerebral ischemia group (n=4), and cerebral hemorrhage group (n=2). The plasma levels of S1P were highest in the thromboembolism group and lowest in the cerebral hemorrhage group (P=0.003).Conclusions: Plasma levels of S1P were associated with circulating levels of D-dimer, PLT and BVAS in the patients with AAV. Hence, plasma S1P level can be used as a biomarker to predict coagulation-related complications in AAV.
Highlights
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a type of necrotizing vasculitis, with an annual incidence of approximately 10–20 per million [1]
The AAV group and the healthy volunteer group were compared, and one of the groups did not conform to the normal distribution, so the rank-sum test was used (P
The results showed that plasma S1P levels were positively correlated with Birmingham vasculitis activity score (BVAS) (r = 0.443, P=0.004, Figure 2); but not with venous blood C-reactive protein (CRP) (r = −0.830, P=0.609)
Summary
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a type of necrotizing vasculitis, with an annual incidence of approximately 10–20 per million [1]. It can bind to cell-specific receptors, and plays a role in cell growth, proliferation, angiogenesis, inhibition of apoptosis and lymphocyte migration [11]. It is a ligand for a family of five G. protein-coupled receptors (S1PR1–5) [12,13]. Sphingosine-1-phosphate (S1P) plays a significant role in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Plasma S1P level can be used as a biomarker to predict coagulation-related complications in AAV
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