1st Department of Cardiology, Medical School, "Hippokration" Hospital.
1st Department of Ophthalmology, School of Medicine, "Gennimatas" General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
J Glaucoma. 2019 Aug;28(8):749-755. doi: 10.1097/IJG.0000000000001303.
PRéCIS:: Pseudoexfoliative glaucoma (PExG) patients present with not only endothelial dysfunction and arterial stiffness but also with a specific profile of circulating apoptotic endothelial microparticles which may be owing to the accumulation of pseudoexfoliative material in vessels walls.
PExG is characterized by the deposition of pseudoexfoliative material in several tissues and organs including in the cardiovascular system. This study aimed to evaluate the vascular endothelial function, arterial stiffness, inflammatory status, and circulating microparticle (MP) levels in PExG patients compared with those in primary open-angle glaucoma (POAG) patients and control subjects.
Vascular endothelial function was evaluated by flow-mediated dilation. Pulse wave velocity and augmentation index were measured as indices of aortic stiffness and arterial wave reflections, respectively. Growth-differentiation factor-15 and intercellular adhesion molecule1 levels were measured to evaluate the systemic inflammatory status. Circulating MPs that constitute an emerging marker of vascular endothelial dysfunction and platelet activation were isolated and analyzed by flow cytometry.
There was a stepwise impairment from the control to the POAG patients and PExG subjects in the flow-mediated dilation (8.21%±2.94% vs. 7.56%±3.12% vs. 5.79±3.13, P=0.005), pulse wave velocity (8.14±1.79 vs. 9.21±2.27 vs. 9.95±3.28 m/s, P=0.007), augmentation index (24.71%±7.84% vs. 26.78%±7.21% vs. 29.96%±7.58%, P=0.02), and growth-differentiation factor-15 (P=0.001) and intercellular adhesion molecule1 levels (P=0.08). PExG patients expressed greater levels of total circulating MPs (Annexin V+) (P=0.004) and endothelial-derived MPs (CD144+) (P<0.001) compared with POAG and control subjects.
PExG patients with an accumulation of pseudoexfoliative microfibrillar material presented with vascular endothelial dysfunction and arterial wall impairment associated with the levels of circulating proinflammatory molecules and circulating apoptotic endothelial MPs. These findings highlight the underlying systemic pathophysiological mechanisms associated with the progress of the pseudoexfoliative syndrome.
PExG 的特征是在包括心血管系统在内的几种组织和器官中沉积假性剥脱物质。本研究旨在评估 PExG 患者与原发性开角型青光眼 (POAG) 患者和对照组患者的血管内皮功能、动脉僵硬度、炎症状态和循环微粒 (MP) 水平。
通过血流介导的扩张评估血管内皮功能。脉搏波速度和增强指数分别作为主动脉僵硬度和动脉波反射的指标进行测量。生长分化因子 15 和细胞间黏附分子 1 水平用于评估全身炎症状态。通过流式细胞术分离和分析构成血管内皮功能障碍和血小板活化的新兴标志物的循环 MPs。
从对照组到 POAG 患者和 PExG 患者，血流介导的扩张（8.21%±2.94%vs.7.56%±3.12%vs.5.79%±3.13，P=0.005）、脉搏波速度（8.14%±1.79%vs.9.21%±2.27%vs.9.95%±3.28 m/s，P=0.007）、增强指数（24.71%±7.84%vs.26.78%±7.21%vs.29.96%±7.58%，P=0.02）和生长分化因子 15（P=0.001）和细胞间黏附分子 1 水平（P=0.08）呈逐渐下降趋势。与 POAG 和对照组相比，PExG 患者的总循环 MPs（膜联蛋白 V+）（P=0.004）和内皮衍生 MPs（CD144+）（P<0.001）水平更高。
积累假性剥脱微纤维物质的 PExG 患者表现出血管内皮功能障碍和动脉壁损伤，与循环促炎分子和循环凋亡内皮 MPs 的水平相关。这些发现强调了与假性剥脱综合征进展相关的潜在全身病理生理机制。
