Circulating endothelial cells in essential thrombocythemia and polycythemia vera: correlation with JAK2-V617F mutational status, angiogenic factors and coagulation activation markers

This study aimed to determine whether the vascular endothelial growth factor (VEGF) family members soluble VEGF receptor 1 (also called soluble fms-like tyrosine kinase 1 (sFlt-1)) and placental growth factor (PlGF) could be used as biomarkers for pulmonary hypertension (PH).Consecutive patients undergoing right heart catheterisation were enrolled (those with mean pulmonary arterial pressure ⩾25 mmHg were classed as having PH; those with mean pulmonary arterial pressure <25 mmHg acted as non-PH controls). Plasma from the time of PH diagnosis was analysed for PlGF and sFlt-1 using enzyme immunoassays.In total, 247 patients with PH were enrolled: 62 with idiopathic pulmonary arterial hypertension (IPAH), 14 with associated pulmonary arterial hypertension (APAH), 21 with collagen vascular disease (CVD), 26 with pulmonary venous hypertension, 67 with lung disease-associated PH and 57 with chronic thromboembolic PH. The non-PH control group consisted of 40 patients. sFlt-1 plasma levels were significantly higher in patients with IPAH, APAH, CVD and lung disease-associated PH versus controls; PlGF levels were significantly higher in all PH groups versus controls. The combination of sFlt-1 and PlGF resulted in a sensitivity of 83.7% with specificity of 100% for pulmonary arterial hypertension. There was no association between sFlt-1 or PlGF and haemodynamic parameters, 6-min walking distance or survival.In summary, PlGF and sFlt-1 are promising diagnostic biomarkers for PH.@ERSpublications This study shows a high potential for VEGF family members as diagnostic biomarkers for pulmonary hypertension

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“…for PlGF [32]. Our control group shows higher levels for both biomarkers, but still significantly lower levels than PH patients.…”

Section: Discussioncontrasting

confidence: 46%

New potential diagnostic biomarkers for pulmonary hypertension

Tiede

Gall

Dörr³

et al. 2015

Eur Respir J

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“…Our results also showed that CEC numbers are significantly higher in patients with VTE and MPN, as compared to healthy individuals. Increased numbers of CEC in patients with ET and PV have already been reported in a previous study [29].…”

Section: Discussionsupporting

confidence: 78%

“…The identification and quantification of the EC in the blood is technically very difficult and not yet well standardized [13], which probably explains the wide range of CEC numbers described in healthy individuals (4 to 7900 cells/ml) [10], [29]. Nevertheless, efforts have been made to define correctly the CEC, as well as the CEP, and there is evidence that these two EC populations can reveal endothelial injury and endothelial repair, respectively.…”

Section: Discussionmentioning

confidence: 99%

Circulating Endothelial Cells in Patients with Venous Thromboembolism and Myeloproliferative Neoplasms

et al. 2013

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BackgroundCirculating endothelial cells (CEC) may be a biomarker of vascular injury and pro-thrombotic tendency, while circulating endothelial progenitor cells (CEP) may be an indicator for angiogenesis and vascular remodelling. However, there is not a universally accepted standardized protocol to identify and quantify these cells and its clinical relevancy remains to be established.ObjectivesTo quantify CEC and CEP in patients with venous thromboembolism (VTE) and with myeloproliferative neoplasms (MPN), to characterize the CEC for the expression of activation (CD54, CD62E) and procoagulant (CD142) markers and to investigate whether they correlate with other clinical and laboratory data.Patients and MethodsSixteen patients with VTE, 17 patients with MPN and 20 healthy individuals were studied. The CEC and CEP were quantified and characterized in the blood using flow cytometry, and the demographic, clinical and laboratory data were obtained from hospital records.ResultsWe found the CEC counts were higher in both patient groups as compared to controls, whereas increased numbers of CEP were found only in patients with MPN. In addition, all disease groups had higher numbers of CD62E+ CEC as compared to controls, whereas only patients with VTE had increased numbers of CD142+ and CD54+ CEC. Moreover, the numbers of total and CD62+ CEC correlated positively with the white blood cells (WBC) counts in both groups of patients, while the numbers of CEP correlated positively with the WBC counts only in patients with MPN. In addition, in patients with VTE a positive correlation was found between the numbers of CD54+ CEC and the antithrombin levels, as well as between the CD142+ CEC counts and the number of thrombotic events.ConclusionsOur study suggests that CEC counts may reveal endothelial injury in patients with VTE and MPN and that CEC may express different activation-related phenotypes depending on the disease status.

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“…25 However, the increased D-dimer level has not been proven as a clinically useful predictor for thrombosis, when compared with some other confirmed predictors such as age and history of thrombosis or leukocytosis. 26,27 In patients with ET we did not find an increase in factor VIII activity, trombinanti-thrombin complexes and prothrombin fragments F1 + F2 levels or protein C activity.…”

Section: Discussionmentioning

confidence: 51%