Correlation of Autoimmune Reactivity and Vasomotor Endothelial Function in Patients with Initial Manifestations of Chronic Cerebral Ischemia
Introduction. Arterial hypertension (AH) is one of the major modified cardiovascular risk factors of chronic cerebral ischemia (ChCI). Endothelial dysfunction is associated with AH and is claimed to be one of the pathogenic mechanisms of the ChCI. We have conducted a study, the objective of which was to evaluate autoimmune reactivity to the structural components of the cardiovascular system, depending on the presence of AH and endothelial dysfunction in patients with initial manifestations of ChCI. Material and methods. We have examined 55 patients of middle age (51.3 ± 7.0 years) with initial manifestations of the ChCI. All patients underwent general clinical, clinical and neurological, clinical and instrumental, clinical and laboratory tests. The level of autoantibodies (autoAB) to platelet antigens, cardiomyocytes and vascular endothelium in the blood serum of patients was determined by the method of O.B. Poletaiev. Endothelial function was assessed in terms of flow-dependent vasodilation, the level of nitrite and endothelin‑1. Results and discussion. Patients with AH and those without AH statistically significantly differed only by the levels of autoAB to PAPP-A and CoM‑02. Depending on the degree of blood pressure (BP) deviation (AH degree I and II, clinical hypotension or normal BP), the patients differed only in terms of average individual level of immune reactivity (AILI) (p = 0.001) and the level of autoAB to DNA (p = 0.015). Statistical analysis showed that patients with AH (stage I and II) and individuals without AH were statistically significantly different in terms of AILI (χ2(3) = 11.5; p = 0.009) and the level of autoAB to DNA (χ2(3) = 8.6; p = 0.04). The percentage of flow-dependent vasodilation statistically significantly correlated with AILI (r = 0.409; p = 0.003), as well as with the level of autoAB to c-ANCA (r = –0.309; p = 0.027) and PAPP-A protein (r = 0.361; p = 0.009). Evaluation of vasomotor endothelial function by content of the biochemical markers discovered that nitrite levels statistically significant correlated with relative content of autoAB to CoS‑05 (r = 0.326; p = 0.033) and the c-ANCA (r = –0.312; p = 0.042) in contrast to endothelin‑1 level, which showed no statistically significant correlations. Conclusions. Patients with AH had an increased activity of cardiodegenerative processes against the background of disturbed regulatory influences on the lipid and carbohydrate metabolism in comparison with individuals without AH, as indicated by the evaluation of autoimmune reactivity in patients with initial manifestations of ChCI depending on the degree of BP disorders. With the development of endothelial dysfunction, according to compression test in patients with initial manifestations of ChCI, there was a downward trend in immune reactivity, endothelial activation and violation of lipid and carbohydrate metabolism regulation.
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