Department of Advanced Preventive Medicine for Infectious Disease, Tohoku University Graduate School of Medicine, 2-1 Seiryoumachi, Aobaku, Sendai 980-8575, Japan.
Thorax. 2012 Dec;67(12):1067-74. doi: 10.1136/thoraxjnl-2011-201395. Epub 2012 Jul 27.
The influence of COPD exacerbation on the endothelium is not completely understood. Circulating endothelial microparticles (EMPs) are membrane vesicles in circulating blood that are shed by activated or apoptotic endothelial cells.
To compare EMP numbers in stable COPD patients with those during and after exacerbation.
We examined the EMP numbers in 80 stable COPD patients, 27 patients with exacerbated COPD, and 20 healthy non-COPD volunteers. EMPs were defined as CD144+ MPs (VE-cadherin EMPs), CD31+/CD41- MPs (PECAM EMPs), CD146 MPs (MCAM EMPs) and CD62E+ EMPs (E-selectin EMPs) as analysed by FACS. Von Willebrand factor (vWF) expression was utilised to identify the origins of the EMPs.
VE-cadherin, PECAM and E-selectin EMP numbers were significantly higher in the stable COPD patients than in the non-COPD volunteers, and they were significantly higher in the patients with exacerbated COPD than in the stable COPD patients. The majority of these increased EMPs were vWF-negative, indicating a pulmonary capillary origin. Baseline E-selectin EMP levels were significantly higher in COPD patients who experienced frequent exacerbations than in those who did not have frequent exacerbations (p<0.001). Twenty-eight days after the onset of exacerbation, E-selectin EMP levels returned to those observed in stable COPD patients, whereas PECAM EMP levels remained high. MCAM EMP numbers were not elevated in stable or exacerbated-COPD patients.
Endothelial damage, mainly in pulmonary capillaries, occurs during exacerbation and continues even after clinical symptoms disappear. Higher baseline E-selectin EMP levels may indicate COPD patients who are susceptible to exacerbation.
COPD 加重对血管内皮的影响尚不完全清楚。循环内皮微颗粒（EMP）是循环血液中由激活或凋亡的内皮细胞释放的膜囊泡。
比较稳定期 COPD 患者与加重期和缓解期的 EMP 数量。
我们检测了 80 例稳定期 COPD 患者、27 例加重期 COPD 患者和 20 例健康非 COPD 志愿者的 EMP 数量。通过流式细胞术将 EMP 定义为 CD144+ MPs（VE-钙黏蛋白 EMP）、CD31+/CD41- MPs（PECAM EMP）、CD146 MPs（MCAM EMP）和 CD62E+ EMP（E-选择素 EMP）。利用血管性血友病因子（vWF）表达来鉴定 EMP 的起源。
稳定期 COPD 患者的 VE-钙黏蛋白、PECAM 和 E-选择素 EMP 数量明显高于非 COPD 志愿者，加重期 COPD 患者明显高于稳定期 COPD 患者。这些增加的 EMP 大多数是 vWF 阴性的，表明来源于肺毛细血管。经历频繁加重的 COPD 患者的基线 E-选择素 EMP 水平明显高于无频繁加重的患者（p<0.001）。加重发作 28 天后，E-选择素 EMP 水平恢复至稳定期 COPD 患者水平，而 PECAM EMP 水平仍较高。稳定期或加重期 COPD 患者的 MCAM EMP 数量未升高。
在加重期发生内皮损伤，主要是在肺毛细血管，即使在临床症状消失后仍持续存在。较高的基线 E-选择素 EMP 水平可能提示 COPD 患者易发生加重。
