Kalashnikova L A, Danilova M S, Shabalina A A, Gubanova M V, Shamtieva K V, Dreval M V, Dobrynina L A
Research Center of Neurology, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2022;122(10):82-87. doi: 10.17116/jnevro202212210182.
To evaluate transforming growth factor beta (TGF-β) in patients with cervical artery dissection (CeAD).
TGF-β was studied by enzyme immunoassay in 74 of 336 patients with CeAD observed at the Research Center of Neurology (Moscow) from 2000 to 2021. The average patient's age at the time of TGF-β study was 41.6±9.8 years; the proportion of women was 51%. TGF-β was studied in the first month of the disease (=9), for 2-3 months (=12) and at a later period (mean - 4.3±5.03 years) (=53). The control group consisted of 20 healthy volunteers, matched for age and sex. Dissection occurred in internal carotid artery (ICA) (=42), vertebral artery (VA) (=29), ICA+VA (=3) and involved 1 artery (=58) or 2-3 arteries (=16). Clinical manifestations included ischemic stroke (IS) (=49), isolated cervical-cephalic headache (=23), lower cranial nerve palsy (=2). Pathological CeAD tortuosity was detected by angiography in 13 patients, and a dissecting aneurysm in 15 patients.
TGF-β1 and TGF-β2 were elevated in patients with CeAD patients compared with the control: TGF-β1 - 4990 [3950; 7900] pg/ml vs. 3645 [3230; 4250] pg/ml, =0.001; TGF-β2 - 6120 [4680; 7900] pg/ml vs. 3155 [2605; 4605] pg/ml, =0.001. The highest TGF-β1 and TGF-β2 levels were noted at 2-3 months of the disease. There was no correlation between the TGF-β level and various clinical and angiographic parameters.
Increased TGF-β level confirms that CeAD patients have connective tissue disorder that underlies the arterial wall weakness. A higher TGF-β level at 2-3 months of CeAD seems to be connected with an active reparative process in arterial wall after dissection. TGF-β can be used as a biomarker of connective tissue dysplasia in patients with CeAD.
评估颈内动脉夹层（CeAD）患者体内的转化生长因子β（TGF-β）。
对2000年至2021年在莫斯科神经病学研究中心观察的336例CeAD患者中的74例进行了酶免疫测定TGF-β。在进行TGF-β研究时，患者的平均年龄为41.6±9.8岁；女性比例为51%。在疾病的第一个月（=9例）、2 - 3个月（=12例）以及后期（平均4.3±5.03年）（=53例）对TGF-β进行了研究。对照组由20名年龄和性别匹配的健康志愿者组成。夹层发生在颈内动脉（ICA）（=42例）、椎动脉（VA）（=29例）、ICA + VA（=3例），累及1条动脉（=58例）或2 - 3条动脉（=16例）。临床表现包括缺血性卒中（IS）（=49例）、孤立性颈 - 头痛（=23例）、下颅神经麻痹（=2例）。13例患者通过血管造影检测到病理性CeAD迂曲，15例患者检测到夹层动脉瘤。
与对照组相比，CeAD患者的TGF-β1和TGF-β2升高：TGF-β1 - 4990 [3950; 7900] pg/ml对3645 [3230; 4250] pg/ml，P = 0.001；TGF-β2 - 6120 [4680; 7900] pg/ml对3155 [2605; 4605] pg/ml，P = 0.001。在疾病的2 - 3个月时，TGF-β1和TGF-β2水平最高。TGF-β水平与各种临床和血管造影参数之间无相关性。
TGF-β水平升高证实CeAD患者存在结缔组织紊乱，这是动脉壁薄弱的基础。CeAD发病2 - 3个月时较高的TGF-β水平似乎与夹层后动脉壁的活跃修复过程有关。TGF-β可作为CeAD患者结缔组织发育异常的生物标志物。
