Lee Po-Tseng, Liao I-Chuang, Lee Cheng-Han, Hsu Ling-Wei, Liu Ping-Yen
Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University.
Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Acta Cardiol Sin. 2021 Nov;37(6):591-599. doi: 10.6515/ACS.202111_37(6).20210701B.
Serving as an inflammatory biomarker in patients under regular hemodialysis (HD), the arterial tissue expression of vascular cell adhesion molecule 1 (VCAM-1) in patients with different renal function has rarely been investigated and remains unclear.
Fifty-one consecutive patients with peripheral arterial disease (PAD) who underwent percutaneous transluminal angioplasty were recruited and divided into a normal renal function group, chronic kidney disease (CKD) group, and HD group. Background disease, clinical and angiographic severity, and serum level of VCAM-1 in the three groups were analyzed. The tissue expression of VCAM-1 was quantitatively demonstrated by immunohistochemical (IHC) staining and protein extraction from cell membranes in another amputated cohort.
In PAD patients, the serum level of VCAM-1 was significantly elevated in the HD group compared with the other two groups (1990.2 ± 607.1 ng/ml vs. 1547.9 ± 511.2 ng/ml vs. 1161.0 ± 435.8 ng/ml, p < 0.001). Serum VCAM-1 was a prognostic factor of major adverse cardiac or limb events (odds ratio: 1.002, 95% confidence interval: 1.001-1.003, p = 0.003). The expression of VCAM-1 was higher in the PAD amputated arterial tissue of CKD and HD patients as demonstrated by quantitative analysis of IHC staining and quantitative membrane protein extraction.
VCAM-1 is a cardiovascular prognostic biomarker. Both serum level and the tissue expression of VCAM-1 were significantly higher in PAD patients with advanced kidney disease.
作为常规血液透析（HD）患者的一种炎症生物标志物，不同肾功能患者血管细胞黏附分子1（VCAM-1）的动脉组织表达情况鲜有研究，目前仍不清楚。
招募51例接受经皮腔内血管成形术的外周动脉疾病（PAD）患者，分为肾功能正常组、慢性肾脏病（CKD）组和HD组。分析三组患者的基础疾病、临床及血管造影严重程度以及VCAM-1的血清水平。在另一组截肢队列中，通过免疫组织化学（IHC）染色和从细胞膜提取蛋白质对VCAM-1的组织表达进行定量分析。
在PAD患者中，HD组的VCAM-1血清水平显著高于其他两组（1990.2±607.1 ng/ml vs. 1547.9±511.2 ng/ml vs. 1161.0±435.8 ng/ml，p<0.001）。血清VCAM-1是主要不良心脏或肢体事件的预后因素（比值比：1.002，95%置信区间：1.001 - 1.003，p = 0.003）。通过IHC染色定量分析和定量膜蛋白提取表明，CKD和HD患者的PAD截肢动脉组织中VCAM-1的表达更高。
VCAM-1是一种心血管预后生物标志物。在患有晚期肾病的PAD患者中，VCAM-1的血清水平和组织表达均显著升高。
