Biomedical Research Group, Schools of Health Science and Science, Waterford Institute of Technology, Waterford, Ireland.
Departments of Vascular Surgery and Histopathology, Waterford Regional Hospital, Waterford, Ireland; Royal College of Surgeons in Ireland, Dublin, Ireland.
Eur J Vasc Endovasc Surg. 2014 Nov;48(5):489-95. doi: 10.1016/j.ejvs.2014.08.007. Epub 2014 Sep 11.
Cell-derived microparticles (MPs) are small plasma membrane-derived vesicles shed from circulating blood cells and may act as novel biomarkers of vascular disease. We investigated the potential of circulating MPs to predict (a) carotid plaque instability and (b) the presence of advanced carotid disease.
This pilot study recruited carotid disease patients (aged 69.3 ± 1.2 years [mean ± SD], 69% male, 90% symptomatic) undergoing endarterectomy (n = 42) and age- and sex-matched controls (n = 73). Plaques were classified as stable (n = 25) or unstable (n = 16) post surgery using immunohistochemistry. Blood samples were analysed for MP subsets and molecular biomarkers. Odds ratios (OR) are expressed per standard deviation biomarker increase.
Endothelial MP (EMP) subsets, but not any vascular, inflammatory, or proteolytic molecular biomarker, were higher (p < .05) in the unstable than the stable plaque patients. The area under the receiver operator characteristic curve for CD31(+)41(-) EMP in discriminating an unstable plaque was 0.73 (0.56-0.90, p < .05). CD31(+)41(-) EMP predicted plaque instability (OR = 2.19, 1.08-4.46, p < .05) and remained significant in a multivariable model that included transient ischaemic attack symptom status. Annexin V(+) MP, platelet MP (PMP) subsets, and C-reactive protein were higher (p < .05) in cases than controls. Annexin V(+) MP (OR = 3.15, 1.49-6.68), soluble vascular cell adhesion molecule-1 (OR = 1.64, 1.03-2.59), and previous smoking history (OR = 3.82, 1.38-10.60) independently (p < .05) predicted the presence of carotid disease in a multivariable model.
EMP may have utility in predicting plaque instability in carotid patients and annexin V(+) MPs may predict the presence of advanced carotid disease in aging populations, independent of established biomarkers.
细胞衍生的微粒（MPs）是从循环血细胞中脱落的小血浆膜衍生小泡，可能作为血管疾病的新型生物标志物。我们研究了循环 MPs 预测（a）颈动脉斑块不稳定和（b）存在颈动脉疾病的潜力。
这项初步研究招募了颈动脉疾病患者（年龄 69.3±1.2 岁[均值±标准差]，69%为男性，90%有症状），接受内膜切除术（n=42）和年龄、性别匹配的对照组（n=73）。术后使用免疫组织化学将斑块分类为稳定（n=25）或不稳定（n=16）。分析血液样本以确定 MPs 亚群和分子生物标志物。每个生物标志物标准偏差增加的比值比（OR）均有表达。
与稳定斑块患者相比，不稳定斑块患者的内皮 MPs（EMP）亚群更高（p<0.05），但任何血管、炎症或蛋白水解分子生物标志物均未升高。CD31(+)41(-)EMP 区分不稳定斑块的受试者工作特征曲线下面积为 0.73（0.56-0.90，p<0.05）。CD31(+)41(-)EMP 预测斑块不稳定（OR=2.19，1.08-4.46，p<0.05），在包括短暂性脑缺血发作症状状态的多变量模型中仍然具有统计学意义。与对照组相比，膜联蛋白 V(+) MPs、血小板 MPs（PMP）亚群和 C 反应蛋白更高（p<0.05）。膜联蛋白 V(+) MP（OR=3.15，1.49-6.68）、可溶性血管细胞黏附分子-1（OR=1.64，1.03-2.59）和既往吸烟史（OR=3.82，1.38-10.60）在多变量模型中独立（p<0.05）预测了颈动脉疾病的存在。
EMP 可能有助于预测颈动脉患者的斑块不稳定，而膜联蛋白 V(+) MPs 可能有助于预测老年人群中颈动脉疾病的存在，独立于既定的生物标志物。
