Dept of Anaesthesiology and Perioperative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Dept of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Eur Respir J. 2019 Oct 17;54(4). doi: 10.1183/13993003.01188-2018. Print 2019 Oct.
Circulating endothelial microparticles (EMPs) are considered to be markers of endothelial injury, and lung microvascular endothelial cells express higher levels of angiotensin-converting enzyme (ACE). The aim of this study is to examine whether the number of ACE microvascular EMPs could be a prognostic marker for the development of acute respiratory distress syndrome (ARDS) in septic patients.The numbers of EMPs and ACE EMPs in the culture supernatant from human microvascular endothelial cells, as well as in the blood of mouse lung injury models and septic patients (n=82), were examined using flow cytometry.ACE EMPs in the culture supernatant from pulmonary microvascular endothelial cells increased after exposure to an inflammatory stimulus. In the mouse lung injury models, the circulating ACE EMPs and ACE EMP/EMP ratio were higher than in the controls (p<0.001). The ACE EMP/EMP ratio was correlated with the wet/dry lung ratio (r=0.775, p<0.001). The circulating ACE EMPs and ACE EMP/EMP ratio on admission were significantly increased in septic patients who developed ARDS compared with septic patients who did not (p<0.001).Therefore, circulating ACE EMPs may be a prognostic marker for the development of ARDS in the septic patients.
循环内皮微颗粒（EMPs）被认为是内皮损伤的标志物，而肺微血管内皮细胞表达更高水平的血管紧张素转换酶（ACE）。本研究旨在探讨 ACE 微血管 EMP 的数量是否可以作为脓毒症患者发生急性呼吸窘迫综合征（ARDS）的预后标志物。采用流式细胞术检测人微血管内皮细胞培养上清液以及小鼠肺损伤模型和脓毒症患者（n=82）血液中 EMPs 和 ACE EMPs 的数量。炎症刺激后，肺微血管内皮细胞培养上清液中的 ACE EMPs 增加。在小鼠肺损伤模型中，循环 ACE EMPs 和 ACE EMP/EMP 比值高于对照组（p<0.001）。ACE EMP/EMP 比值与湿/干肺比值呈正相关（r=0.775，p<0.001）。与未发生 ARDS 的脓毒症患者相比，发生 ARDS 的脓毒症患者入院时循环 ACE EMPs 和 ACE EMP/EMP 比值明显升高（p<0.001）。因此，循环 ACE EMPs 可能是脓毒症患者发生 ARDS 的预后标志物。
