Year 2018, Volume 10 , Issue 3, Pages 228 - 233 2018-09-30

Pulmoner emboli şüphesi olan hastalarda siklofilin A ve VAP-1’in tanısal değeri
The diagnostic value of cyclophilin A and VAP-1 in patients with suspected pulmonary embolism

Aynur SAHİN [1] , Olgun AŞIK [2] , Özgür TATLI [3] , Yunus KARACA [4] , Selim DEMİR [5] , Ahmet MENTEŞE [6] , Süleyman Caner KARAHAN [7] , Süleyman TÜREDİ [8]


Amaç: Bu çalışmanın amacı endotel hasarı sonucu trombosit aktivasyonu ve kümeleşmesinin patofizyolojisinde rol oynadığı bilinen pulmoner emboli (PE) hastalığında; endotel disfonksiyonu, platelet adezyonu ve arterial trombüs ile ilişkelendirilen siklofilin A (CYPA) ve vasküler adezyon protein- 1 (VAP-1) adlı biyokimyasal belirteçlerin tanısal değerini araştırmaktır.

Gereç ve Yöntem: Prospektif olarak yapılan bu klinik çalışmada acil servise akut PE şüphesi ile başvurarak çalışmaya alınan ve spiral bilgisayarlı tomografi anjiografi ile PE varlığı değerlendirilen 165 hastanın serum CYPA ve VAP-1 düzeyi ölçüldü. Bilgisayarlı tomografi sonuçlarına göre, PE (+) ve PE (-) olarak 2 gruba ayrılan bu hastaların ölçülen CYPA ve VAP-1 düzeyleri birbirleriyle karşılaştırıldı.

Bulgular: Her iki grup ölçümleri birbiriyle karşılaştırıldığında VAP-1 düzeyi bakımından gruplar arası fark istatistiksel anlamlı bulunurken (p=0.0001), CYPA düzeyinin bakımından bu fark istatistiksel olarak anlamlı değildi. (p=0.381).

 

Sonuç: Akut PE’de serum VAP-1 düzeyinin tanısal olarak kullanılabileceği tespit edilmiştir. Serum CYPA düzeyinin ise akut PE’de tanısal değeri bulunmamaktadır.

Aim: To investigate the diagnostic value of the biochemical markers cyclophilin A (CYPA) and VAP-1, associated with endothelial dysfunction, platelet adhesion, and arterial thrombus in pulmonary embolism (PE), in whose pathophysiology platelet activation and aggregation resulting from endothelial damage are known to be involved.

Material and Method: Serum CYPA and VAP-1 levels of 165 patients presenting to the emergency department with suspected acute PE and with presence of PE investigated at spiral computerized tomography angiography were measured in this prospective clinical study. These patients were assigned into two groups, PE (+) and PE (-), based on the tomography results, and their CYPA and VAP-1 levels were then compared.

Results: Comparison of the two groups’ measurements revealed a significant difference in terms of VAP-1 levels (p=0.0001), but none for CYPA (p=0.381).

Conclusion: Diagnostic value was determined for serum VAP-1 levels in acute PE, but CYPA levels are of no such value.

  • Referans1. Konstantinides S, Torbicki A, Agnelli G, et al. ESC/PCS New Guidelines. Kardiol Pol. 2014;72(11):997-1053.
  • Referans2. Bova C, Greco F, Misuraca G, et al. Diagnostic utility of echocardiography in patients with suspected pulmonary embolism. The American journal of emergency medicine. 2003;21(3):180-3.
  • Referans3. Seizer P, Fuchs C, Ungern-Sternberg SN, et al. Platelet-bound cyclophilin A in patients with stable coronary artery disease and acute myocardial infarction. Platelets. 2016;27(2):155-8. doi:10.3109/09537104.2015.1051466.
  • Referans4. Elvers M, Herrmann A, Seizer P, et al. Intracellular cyclophilin A is an important Ca(2+) regulator in platelets and critically involved in arterial thrombus formation. Blood. 2012;120(6):1317-26. doi:10.1182/blood-2011-12-398438.
  • Referans5. Tian-Tian Z, Jun-Feng Z, Heng G. Functions of cyclophilin A in atherosclerosis. Exp Clin Cardiol. 2013;18(2):e118-24.
  • Referans6. Pannecoeck R, Serruys D, Benmeridja L, et al. Vascular adhesion protein-1: Role in human pathology and application as a biomarker. Crit Rev Clin Lab Sci. 2015;52(6):284-300. doi:10.3109/10408363.2015.1050714.
  • Referans7. Smith DJ, Salmi M, Bono P, Hellman J, Leu T, Jalkanen S. Cloning of vascular adhesion protein 1 reveals a novel multifunctional adhesion molecule. J Exp Med. 1998;188(1):17-27.
  • Referans8. Aalto K, Maksimow M, Juonala M, et al. Soluble vascular adhesion protein-1 correlates with cardiovascular risk factors and early atherosclerotic manifestations. Arterioscler ThrombVascBiol.2012;32(2):52332.doi:10.1161/ATVBAHA.111.238030.
  • Referans9. Altug Cakmak H, Aslan S, Erturk M, et al. Assessment of the Relationship Between Serum Vascular Adhesion Protein-1 (VAP-1) and Severity of Calcific Aortic Valve Stenosis. J Heart Valve Dis. 2015;24(6):699-706.
  • Referans10. Chen DW, Zhao RM, Jin Y, et al. Plasma soluble vascular adhesion protein-1 concentration correlates with arterial stiffness: A cross-sectional study. Arch Gerontol Geriatr. 2015;61(1):67-71. doi:10.1016/j.archger.2015.04.007.
  • Referans11. Airas L, Lindsberg PJ, Karjalainen-Lindsberg ML, et al. Vascular adhesion protein-1 in human ischaemic stroke. Neuropathol Appl Neurobiol. 2008;34(4):394-402. doi:10.1111/j.1365-2990.2007.00911.x.
  • Referans12. Aalto K, Havulinna AS, Jalkanen S, Salomaa V, Salmi M. Soluble vascular adhesion protein-1 predicts incident major adverse cardiovascular events and improves reclassification in a finnish prospective cohort study. Circ Cardiovasc Genet. 2014;7(4):529-35. doi:10.1161/CIRCGENETICS.113.000543.
  • Referans13. Sun P, Sole M, Unzeta M. Involvement of SSAO/VAP-1 in oxygen-glucose deprivation-mediated damage using the endothelial hSSAO/VAP-1-expressing cells as experimental model of cerebral ischemia. Cerebrovasc Dis. 2014;37(3):171-80. doi:10.1159/000357660.
  • Referans14. Ma Q, Manaenko A, Khatibi NH, Chen W, Zhang JH, Tang J. Vascular adhesion protein-1 inhibition provides antiinflammatory protection after an intracerebral hemorrhagic stroke in mice. J Cereb Blood Flow Metab. 2011;31(3):881-93. doi:10.1038/jcbfm.2010.167.
  • Referans15. Karaca Y, Tatli O, Aksut, N, et al. Diagnostic Value of Cyclophilin A in Acute Ischemic Stroke. Eurasian J Emerg Med. 2017;16(54):54-6. doi:10.5152/eajem.2017.35119.
  • Referans16. Nigro P, Satoh K, O'Dell MR, Soe NN, Cui Z, Mohan A et al. Cyclophilin A is an inflammatory mediator that promotes atherosclerosis in apolipoprotein E-deficient mice. J Exp Med. 2011;208(1):53-66. doi:10.1084/jem.20101174.
  • Referans17. Satoh K, Nigro P, Matoba T, et al. Cyclophilin A enhances vascular oxidative stress and the development of angiotensin II-induced aortic aneurysms. Nat Med. 2009;15(6):649-56. doi:10.1038/nm.1958.
  • Referans18. Jin ZG, Melaragno MG, Liao DF, et al. Cyclophilin A is a secreted growth factor induced by oxidative stress. Circ Res. 2000;87(9):789-96. 19. Liao DF, Jin ZG, Baas AS, Daum G, Gygi SP, Aebersold R et al. Purification and identification of secreted oxidative stress-induced factors from vascular smooth muscle cells. J Biol Chem. 2000;275(1):189-96. 20. Damsker JM, Bukrinsky MI, Constant SL. Preferential chemotaxis of activated human CD4+ T cells by extracellular cyclophilin A. J Leukoc Biol. 2007;82(3):613-8. doi:10.1189/jlb.0506317.
Primary Language en
Subjects Health Care Sciences and Services
Journal Section Original article
Authors

Author: Aynur SAHİN (Primary Author)
Institution: KARADENİZ TEKNİK ÜNİVERSİTESİ TIP FAKÜLTESİ ACİL TIP ANABİLİMDALI
Country: Turkey


Author: Olgun AŞIK
Institution: SAĞLIK BİLİMLERİ ÜNİVERSİTESİ TRABZON KANUNİ EĞİTİM ARAŞTIRMA HASTANESİ ACİL TIP ANABİLİMDALI
Country: Turkey


Author: Özgür TATLI
Institution: KARADENİZ TEKNİK ÜNİVERSİTESİ TIP FAKÜLTESİ ACİL TIP ANABİLİMDALI

Author: Yunus KARACA
Institution: KARADENİZ TEKNİK ÜNİVERSİTESİ TIP FAKÜLTESİ ACİL TIP ANABİLİMDALI

Author: Selim DEMİR
Institution: KARADENİZ TEKNİK ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ, BESLENME VE DİYETETİK BÖLÜMÜ

Author: Ahmet MENTEŞE
Institution: KARADENİZ TEKNİK ÜNİVERSİTESİ SAĞLIK HİZMETLERİ MESLEK YÜKSEK OKULU TIBBI LABORATUVAR TEKNİKLERİ ANABİLİMDALI

Author: Süleyman Caner KARAHAN
Institution: KARADENİZ TEKNİK ÜNİVERSİTESİ TIP FAKÜLTESİ TIBBİ BİYOKİMYA ANABİLİMDALI

Author: Süleyman TÜREDİ
Institution: KARADENİZ TEKNİK ÜNİVERSİTESİ TIP FAKÜLTESİ ACİL TIP ANABİLİMDALI

Dates

Publication Date : September 30, 2018

Vancouver Sahi̇n A , Aşık O , Tatlı Ö , Karaca Y , Demi̇r S , Menteşe A , Karahan S , Türedi̇ S . The diagnostic value of cyclophilin A and VAP-1 in patients with suspected pulmonary embolism. Ortadoğu Tıp Dergisi. 2018; 228-233.