Constans Joël, Conri Claude
Service de Médecine Interne et Médecine Vasculaire, Hôpital Saint-André, 1 rue Jean Burguet, 33075 Bordeaux And EA 3670, Université Victor Segalen-Bordeaux II, 146 rue Léo Saignat, 33000 Bordeaux, France.
Clin Chim Acta. 2006 Jun;368(1-2):33-47. doi: 10.1016/j.cca.2005.12.030. Epub 2006 Mar 10.
Endothelial dysfunction is a key event in cardiovascular disease. Measurement of endothelial dysfunction in vivo presents a major challenge, but has important implications since it may identify the clinical need for therapeutic intervention, specifically in primary prevention. Several biological markers have been used as indicators of endothelial dysfunction. The soluble adhesion molecules sICAM-1 and sVCAM-1 lack specificity and are increased in inflammatory processes. Both markers are increased in coronary artery disease. sICAM-1 level predicts the risk for cardiovascular disease or diabetes mellitus in healthy individuals. sE-selectin is specific for the endothelium and is increased in coronary artery disease and diabetes mellitus. sE-selectin is also associated with diabetic risk. The endothelium-specific marker, soluble thrombomodulin, is associated with severity of coronary artery disease, stroke or peripheral occlusive arterial disease and is not increased in healthy or asymptomatic subjects. Interestingly, thrombomodulin decreases during treatment of hypercholesterolemia or hyperhomocysteinemia. In contrast, von Willebrand factor is the best endothelial biomarker and predicts risk for ischemic heart disease or stroke.
内皮功能障碍是心血管疾病中的关键事件。体内内皮功能障碍的测量是一项重大挑战，但具有重要意义，因为它可能确定临床对治疗干预的需求，特别是在一级预防中。几种生物标志物已被用作内皮功能障碍的指标。可溶性黏附分子sICAM - 1和sVCAM - 1缺乏特异性，且在炎症过程中会升高。这两种标志物在冠状动脉疾病中均升高。sICAM - 1水平可预测健康个体患心血管疾病或糖尿病的风险。sE - 选择素对内皮具有特异性，在冠状动脉疾病和糖尿病中会升高。sE - 选择素也与糖尿病风险相关。内皮特异性标志物可溶性血栓调节蛋白与冠状动脉疾病、中风或外周闭塞性动脉疾病的严重程度相关，在健康或无症状受试者中不会升高。有趣的是，在高胆固醇血症或高同型半胱氨酸血症治疗期间，血栓调节蛋白会降低。相比之下，血管性血友病因子是最佳的内皮生物标志物，可预测缺血性心脏病或中风的风险。
