Akkoca Muzaffer, Usanmaz Suzan Emel, Koksoy Cuneyt, Bengisun Ugur, Demirel-Yilmaz Emine
Department of Peripheral Vascular Surgery, Ankara University, Faculty of Medicine, Sihhiye, Ankara, Turkey.
Department of Medical Pharmacology, Ankara University, Faculty of Medicine, Sihhiye, Ankara, Turkey.
Clin Hemorheol Microcirc. 2017;65(2):151-162. doi: 10.3233/CH-16143.
At present there is no widely accepted biomarker for monitoring of vascular functions. The purpose of this prospective study was to investigate the association of some blood biomarkers with vascular reactivity in patients with peripheral arterial diseases (PAD). A prospective evaluation was made of 3 groups comprising a control group of healthy individuals, and patients with PAD caused by either atherosclerosis or Buerger's disease. Microvascular perfusion was examined using laser Doppler imaging of cutaneous erythrocyte flux after iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP). The correlation of microvascular reactivity with endothelium-related biomarkers was assessed. ACh-induced and SNP-induced vasodilations were significantly diminished in the PAD groups. The plasma nitric oxide (NO) levels of PAD patients were significantly higher than those of the control group, but asymmetric dimethylarginine, total antioxidant capacity and hydrogen sulphide levels were similar. Plasma NO level was negatively correlated with ACh and SNP-stimulated microvascular flow increase, whereas a positive correlation was detected with blood glucose and glycated hemoglobin (HbA1c) levels in all groups. These results indicate that a high plasma level of NO in PAD patients is associated with diminished endothelium-dependent and independent flow increase in the microvascular bed. An excessive amount of NO-induced nitrosative stress in an inflammatory condition that might be a reason for vascular dysfunction should be taken into consideration in the diagnostic and therapeutic approaches to PAD.
目前，尚无广泛接受的用于监测血管功能的生物标志物。这项前瞻性研究的目的是调查外周动脉疾病（PAD）患者中某些血液生物标志物与血管反应性之间的关联。对3组进行了前瞻性评估，包括一组健康个体对照组以及由动脉粥样硬化或血栓闭塞性脉管炎引起的PAD患者。在乙酰胆碱（ACh）和硝普钠（SNP）离子电渗疗法后，使用激光多普勒成像检测皮肤红细胞通量来检查微血管灌注。评估微血管反应性与内皮相关生物标志物之间的相关性。在PAD组中，ACh诱导的和SNP诱导的血管舒张明显减弱。PAD患者的血浆一氧化氮（NO）水平显著高于对照组，但不对称二甲基精氨酸、总抗氧化能力和硫化氢水平相似。血浆NO水平与ACh和SNP刺激的微血管血流增加呈负相关，而在所有组中均与血糖和糖化血红蛋白（HbA1c）水平呈正相关。这些结果表明，PAD患者血浆中高水平的NO与微血管床中内皮依赖性和非依赖性血流增加减弱有关。在PAD的诊断和治疗方法中，应考虑在炎症状态下过量的NO诱导的亚硝化应激可能是血管功能障碍的一个原因。
