Basic Jelena, Stojkovic Stefan, Assadian Afshin, Rauscher Sabine, Duschek Nikolaus, Kaun Christoph, Wojta Johann, Falkensammer Jürgen
Department of Vascular and Endovascular Surgery, Wilhelminenspital, Vienna, Austria; 2nd Medical Department with Cardiology and Intensive Care Medicine, KA Rudolfstiftung, Vienna, Austria.
Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
J Stroke Cerebrovasc Dis. 2019 Jun;28(6):1540-1545. doi: 10.1016/j.jstrokecerebrovasdis.2019.03.009. Epub 2019 Apr 2.
Stroke is one of the leading causes of morbidity and mortality. Thromboembolism, as a major cause of carotid artery-related stroke, can be caused by plaque rupture which is associated with neoangiogenesis within the carotid plaque.
We sought to investigate a possible correlation between angiogenesis-related factors and preoperative neurological manifestations in patients with internal carotid artery stenosis, for a better understanding of thromboembolism in internal carotid artery stenosis-related stroke.
This study included 54 patients (asymptomatic, n = 20 and symptomatic, n = 34) undergoing carotid endarterectomy for high-grade internal carotid artery stenosis. In the retrieved carotid plaques, angiogenesis-related factors (vascular endothelial growth factor [VEGF], hypoxia inducible factor-1 alpha [HIF-1α], and Clusterin) were measured by immunohistochemistry and quantified by real-time polymerase chain reaction.
We demonstrated the expression of VEGF, HIF-1α, and Clusterin by endothelial cells and smooth muscle cells in the carotid plaques. Noteworthy, mRNA VEGF levels were .7-fold higher in symptomatic patients (P = .017) compared to asymptomatic patients. In contrast, mRNA Clusterin levels were 1.8-fold lower (P = .021). Levels of mRNA HIF-1α were 1.5-fold higher in asymptomatic patients, but no statistical significance was reached between the 2 groups.
Our results show an association between VEGF and Clusterin and neurological symptoms of patients with high-grade carotid artery stenosis.
中风是发病和死亡的主要原因之一。血栓栓塞作为颈动脉相关中风的主要原因，可由斑块破裂引起，而斑块破裂与颈动脉斑块内的新生血管形成有关。
我们试图研究血管生成相关因子与颈内动脉狭窄患者术前神经学表现之间的可能相关性，以便更好地理解颈内动脉狭窄相关中风中的血栓栓塞。
本研究纳入了54例因重度颈内动脉狭窄接受颈动脉内膜切除术的患者（无症状患者20例，有症状患者34例）。在获取的颈动脉斑块中，通过免疫组织化学检测血管生成相关因子（血管内皮生长因子[VEGF]、缺氧诱导因子-1α[HIF-1α]和聚集素），并通过实时聚合酶链反应进行定量分析。
我们证实了颈动脉斑块中内皮细胞和平滑肌细胞表达VEGF、HIF-1α和聚集素。值得注意的是，有症状患者的VEGF mRNA水平比无症状患者高0.7倍（P = 0.017）。相比之下，聚集素mRNA水平低1.8倍（P = 0.021）。无症状患者的HIF-1α mRNA水平高1.5倍，但两组之间未达到统计学显著性。
我们的结果表明VEGF和聚集素与重度颈动脉狭窄患者的神经症状之间存在关联。
