Division of Immunology and Allergic Diseases, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Department of Cardiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Ann Allergy Asthma Immunol. 2021 Jul;127(1):76-82. doi: 10.1016/j.anai.2021.03.020. Epub 2021 Mar 26.
Knowledge on endothelial dysfunction and its relation to atherosclerosis in mastocytosis is limited.
To investigate the endothelial function in mastocytosis by flow-mediated dilatation (FMD) and biomarkers related to vascular endothelia and to evaluate its relationship with the presence of subclinical atherosclerosis by carotid intima media thickness (CIMT).
A total of 49 patients with mastocytosis and 25 healthy controls (HCs) were included. The FMD and CIMT during transthoracic echocardiography biomarkers including endocan, endothelin-1, and vascular endothelial growth factor (VEGF) were measured in the sera of participants. Tumor necrosis factor-alpha, interleukin 6, and high-sensitive C-reactive protein were determined as inflammatory biomarkers.
The mean FMD % was lower in the patients than HCs (11.26% ± 5.85% vs 17.84% ± 5.27% P < .001) and was the lowest in the advanced systemic mastocytosis and smoldering systemic mastocytosis group among the patients (P = .03). The median value of VEGF was considerably higher in patients than HCs (73.30 pg/mL; minimum-maximum 32.46-295.29 pg/mL vs 46.64 pg/mL; minimum-maximum, 11.09-99.86 pg/mL; P = .001) and it was the highest in the advanced systemic mastocytosis and smoldering systemic mastocytosis group (P = .01). The FMD was inversely correlated with endocan (r = -0.390; P = .006), endothelin-1 (r = -0.363; P = .01) and VEGF (r = -0.402; P = .004) but there were no correlations between FMD and tumor necrosis factor-alpha, interleukin 6, and high-sensitive C-reactive protein. No differences in CIMT values between patients and HCs and no correlation between CIMT and the biomarkers were observed.
Endothelial dysfunction in mastocytosis becomes evident with decreased FMD and elevated serum VEGF in the absence of atherosclerosis or systemic inflammation and is related to disease severity.
目前关于肥大细胞增多症中内皮功能障碍及其与动脉粥样硬化的关系的知识有限。
通过血流介导的扩张（FMD）和与血管内皮相关的生物标志物来研究肥大细胞增多症中的内皮功能，并通过颈动脉内膜中层厚度（CIMT）来评估其与亚临床动脉粥样硬化的关系。
共纳入 49 例肥大细胞增多症患者和 25 名健康对照者（HCs）。在参与者的血清中测量了经胸超声心动图的 FMD 和 CIMT 以及包括内皮素-1、血管内皮生长因子（VEGF）和内脂素在内的生物标志物。肿瘤坏死因子-α、白细胞介素 6 和高敏 C 反应蛋白被确定为炎症生物标志物。
与 HCs 相比，患者的平均 FMD%较低（11.26%±5.85%比 17.84%±5.27%，P<0.001），其中晚期系统性肥大细胞增多症和潜伏性系统性肥大细胞增多症患者的 FMD%最低（P=0.03）。与 HCs 相比，患者的 VEGF 中位数明显较高（73.30 pg/mL；最小-最大 32.46-295.29 pg/mL 比 46.64 pg/mL；最小-最大 11.09-99.86 pg/mL；P=0.001），且在晚期系统性肥大细胞增多症和潜伏性系统性肥大细胞增多症患者中最高（P=0.01）。FMD 与内脂素（r=-0.390；P=0.006）、内皮素-1（r=-0.363；P=0.01）和 VEGF（r=-0.402；P=0.004）呈负相关，但 FMD 与肿瘤坏死因子-α、白细胞介素 6 和高敏 C 反应蛋白之间无相关性。患者与 HCs 的 CIMT 值无差异，且 CIMT 与生物标志物之间无相关性。
肥大细胞增多症中的内皮功能障碍表现为 FMD 降低和血清 VEGF 升高，而无动脉粥样硬化或全身炎症，且与疾病严重程度相关。
