Silambanan Santhi, Hermes R S, Bhaskar Emmanuel, Gayathri Sri
Department of Biochemistry, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai 600116 India.
Department of General Medicine, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai 600116 India.
Indian J Clin Biochem. 2020 Apr;35(2):245-250. doi: 10.1007/s12291-019-00861-w. Epub 2019 Nov 28.
Hypertension is a global health burden causing immense morbidity and mortality especially from the complications of end-organ damage. It is expected to affect 29% of the population by the year 2025. Hypertension is usually asymptomatic; it is diagnosed by a disease of exclusion. Numerous factors such as inflammation, oxidative stress, genetic predisposition etc. play roles in the pathogenesis of hypertension. Endothelial microparticles (EMPs) are released into the circulation with the onset of changes in endothelium, even before the release of other routine vascular endothelial markers. EMPs mediate inflammation, thrombosis and vasoconstriction of blood vessels in hypertensives. This pilot study was undertaken to assess whether EMPs are early markers of endothelial dysfunction in essential hypertensive patients. The study was conducted as a large case control study in which 525 individuals were involved. It consisted of three study groups: Group I: individuals with normal blood pressure (JNC8), group II: hypertensives without evidence of end-organ damage and group III: hypertensives with evidence of end-organ damage. Homocysteine, hsCRP, fibrinogen, eNOS, oxLDL and other markers were measured. For analysis of EMPs a subset of individuals are taken from each group. Control group of 10 individuals who had homocysteine level more than15μmol/L was taken as Group I. Another 10 individuals were taken randomly of five each from groups II and III. EMPs were analyzed by flow cytometry and were identified as CD31 +, CD42 - microparticles with diameters < 1.0 mm. There was significant increase in EMPs (= 0.035) in hypertensive individuals with end organ damage. Measurement of EMPs in hypertensive individuals could help physicians in identifying and initiating therapeutic interventions at a very early stage of the disease, thus improving the quality of life.
高血压是一种全球健康负担，尤其会因终末器官损害的并发症导致巨大的发病率和死亡率。预计到2025年，它将影响29%的人口。高血压通常无症状；它是通过排除性疾病来诊断的。炎症、氧化应激、遗传易感性等众多因素在高血压的发病机制中起作用。内皮微粒（EMPs）在血管内皮发生变化时就会释放到循环中，甚至在其他常规血管内皮标志物释放之前。EMPs介导高血压患者血管的炎症、血栓形成和血管收缩。这项初步研究旨在评估EMPs是否是原发性高血压患者内皮功能障碍的早期标志物。该研究作为一项大型病例对照研究进行，涉及525名个体。它由三个研究组组成：第一组：血压正常的个体（JNC8），第二组：无终末器官损害证据的高血压患者，第三组：有终末器官损害证据的高血压患者。测量了同型半胱氨酸、hsCRP、纤维蛋白原、eNOS、氧化型低密度脂蛋白和其他标志物。为了分析EMPs，从每组中选取一部分个体。将10名同型半胱氨酸水平超过15μmol/L的个体作为第一组对照组。另外从第二组和第三组中每组随机选取5名个体，共10名。通过流式细胞术分析EMPs，并将其鉴定为直径<1.0mm的CD31 +、CD42 - 微粒。有终末器官损害的高血压个体中EMPs显著增加（= 0.035）。测量高血压个体中的EMPs可以帮助医生在疾病的非常早期阶段识别并启动治疗干预，从而提高生活质量。
