Correlation of Autoimmune Reactivity and Vasomotor Endothelial Function in Patients with Initial Manifestations of Chronic Cerebral Ischemia

M.A. Trishchynska

Abstract


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.


Keywords


chronic cerebral ischemia; initial manifestations; arterial hypertension; autoimmune reactivity; endothelial function

References


Бисярина В.П. Артериальные сосуды и возраст / В.П. Бисярина, В.М. Яковлев, П.Я. Кукса. — ​М.: Медицина, 1986. — 224 с.

Кузьменко Л.Г. Методы группы ЭЛИ-Тест в клинической лабораторной практике / Л.Г. Кузьменко, А.Б. Полетаев. — ​М.: Мед. информационное агентство, 2004. — 46 с.

Лелюк В.Г. Церебральное кровообращение и артериальное давление / В.Г. Лелюк, С.Э. Лелюк. — ​М.: Реальное время, 2004. — ​С. 304.

Bian K. Nitric oxide — ​biogeneration, regulation, and relevance to human diseases [Text] / K. Bian, F. Murad // Frontiers in Bioscience. — 2003. — № 8. — ​Р. 264-278.

Celermajer D.S. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis [Text] / D.S. Celermajer, K.E. Sorensen, V.M. Goochetal // Lancet. — 1992. — ​Vol. 340. — ​P. 1111-1115.

Davignon J. Role of Endothelial Dysfunction in Atherosclerosis [Text] / J. Davignon, P. Ganz // Circulation. — 2004. — № 109. — ​Р. 27-32.

Galley H.F. Physiology of the endothelium [Text] / H.F. Galley, N.R. Webster // British Journal of Anaesthesia. — 2004. — № 93(1). — ​Р. 105-13.

Goff D.C. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk [Text] / D.C. Goff, D.M. Lloyd-Jones, G. Bennett, S. Coady, R.B. D’Agostino, R. Gibbons et al. // Circulation. — 2013. — ​Vol. 129, Issue 25. — ​P. S49–S73. doi: 10.1161/01.cir.0000437741.48606.98.

Guidelines for the Primary Prevention of Stroke [Text] / J.F. Meschia, C. Bushnell, B. Boden-Albala, L.T. Braun, D.M. Bravata, S. Chaturvedi et al. // Stroke. — 2014. — ​Vol. 45, Issue 12. — ​P. 3754-3832. doi: 10.1161/str.0000000000000046.

Kuvin J.T. Clinical utility of endothelial function testing: ready for prime time? / J.T. Kuvin, R.H. Karas // Circulation. — 2003. — № 107(25). — ​Р. 3243-3247.

Mancia G. 2013 ESH/ESC Guidelines for the management of arterial hypertension [Text] / G. Mancia, R. Fagard, K. Narkiewicz et al. // J. Hypertens. — 2013. — № 31. — ​Р. 1281-1357.

Pepine C.J. Why vascular biology metters? [Text] / C.J. Pe­pine // Am. J. Cardiology. — 2001. — № 88(8).

Radegran G. Nitric oxide in the regulation of vasomotor tone in human skeletal muscle [Text] / G. Radegran, B. Saltin // Am. J. Physiol. Heart Circ. Physiol. — 1999. — ​Vol. 276. — ​P. 1951-1960.

Ruschitzka F.T. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration [Text] / J. Wardlaw, E. Smith, Ch. Cordonnier еt al. // Lancet Neurol. — 2013. — № 12. — ​P. 822-38.

Wardlaw J.M. Neuroimaging standards for research into small vessel disease and its contribution to age in gandneurodegeneration [Text] / J.M. Wardlaw, E.E. Smith, G.J. Biessels, C. Cordonnier, F. Fazekas, R. Frayne et. al // The Lancet Neurology. — 2013. — ​Vol. 12, Issue 8. — ​P. 822-838. doi: 10.1016/s1474-4422(13)70124-8.

White W.B. Blood pressure load and target organ effects in patients with essential hypertension [Text] / W.B. White // J. Hypertens. — 1991. — № 9 (Suppl. 8). — ​Р. 39–S41.




DOI: https://doi.org/10.22141/2224-0713.4.82.2016.77698

Refbacks

  • There are currently no refbacks.


Copyright (c) 2016 INTERNATIONAL NEUROLOGICAL JOURNAL

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2017

 

 Яндекс.МетрикаSeo анализ сайта Рейтинг@Mail.ru