Budzyń Magdalena, Iskra Maria, Turkiewicz Wojciech, Krasiński Zbigniew, Gryszczyńska Bogna, Kasprzak Magdalena Paulina
Department of General Chemistry, Chair of Chemistry and Clinical Biochemistry, Poznan University of Medical Sciences, Poznań, Poland.
Department of General Surgery, Medical Center HCP, Poznań, Poland.
PLoS One. 2018 Jan 29;13(1):e0191902. doi: 10.1371/journal.pone.0191902. eCollection 2018.
Although the endothelial dysfunction is considered to be implicated in the pathogenesis of chronic venous insufficiency (CVI) the endothelial status in patients with venous disorders is still not fully evaluated. Therefore the aim of the study was to measure the concentration of selected markers of endothelial dysfunction: von Willebrand factor (vWf), soluble P-selectin (sP-selectin), soluble thrombomodulin (sTM) and soluble VE-cadherin (sVE-cadherin) in CVI women who constitute the most numerous group of patients suffering from venous disease.
Forty four women with CVI were involved in the study and divided into subgroups based on CEAP classification. Concentration of vWf, sP-selectin, sTM and sVE-cadherin were measured and compared with those obtained in 25 healthy age and sex-matched women.
It was found that the concentration of sTM increased and sVEcadherin decreased along with disease severity in CVI women. A significant rise of sTM was observed especially in CVI women, with the highest inflammation status reflected by hsCRP or elastase concentration, and in CVI women with a high oxidative stress manifested by an increased plasma MDA. A significant fall of circulating sVE-cadherin was reported in CVI women with moderate to highest intensity of inflammation and oxidative stress. There was no change in vWF and sP-selectin concentration at any stage of CVI severity.
The results of the present study demonstrate the presence of endothelial dysfunction in women suffering from CVI which seems to progress with the disease severity and may be associated with inflammation and enhanced oxidative stress.
尽管内皮功能障碍被认为与慢性静脉功能不全（CVI）的发病机制有关，但静脉疾病患者的内皮状态仍未得到充分评估。因此，本研究的目的是测量内皮功能障碍的选定标志物的浓度：血管性血友病因子（vWf）、可溶性P-选择素（sP-选择素）、可溶性血栓调节蛋白（sTM）和可溶性血管内皮钙黏蛋白（sVE-钙黏蛋白），这些患者为患有静脉疾病的最庞大群体，即CVI女性患者。
44名患有CVI的女性参与了本研究，并根据CEAP分类分为亚组。测量vWf、sP-选择素、sTM和sVE-钙黏蛋白的浓度，并与25名年龄和性别匹配的健康女性的测量结果进行比较。
研究发现，CVI女性患者中，sTM的浓度随着疾病严重程度的增加而升高，而sVE-钙黏蛋白的浓度则下降。尤其在hsCRP或弹性蛋白酶浓度反映出炎症状态最高的CVI女性患者中，以及血浆MDA升高表明存在高氧化应激的CVI女性患者中，观察到sTM显著升高。在炎症和氧化应激强度为中度至最高的CVI女性患者中，循环sVE-钙黏蛋白显著下降。在CVI严重程度的任何阶段，vWF和sP-选择素的浓度均无变化。
本研究结果表明，患有CVI的女性存在内皮功能障碍，这种功能障碍似乎随着疾病严重程度的增加而进展，并且可能与炎症和氧化应激增强有关。
