| Abstract [eng] |
The Relationship Between Endothelin-1 and Inflammatory Markers in ANCA Positive Patients Background: vasculitides associated with anti-neutrophil cytoplasmic antibodies (ANCAs) are systemic autoimmune diseases that affect small to medium sized blood vessels. Although they are relatively rare, they must be diagnosed and treated early because untreated disease may rapidly develop into multiple organ failure and death. Endothelin-1 (ET-1) is not only a potent endogenous vasoconstrictor, which mediates proliferation and fibrosis of vascular wall cells, but also is a proinflammatory protein, which leads to activation of macrophages and adhesion of neutrophils. ET-1 is not a marker used in a daily routine, but, according to scientists, it can be used to determined endothelial damage. The aim of the study was to assess the relationship of endothelin and ANCA by investigating ET-1 concentration and its connection with inflammatory markers in ANCA positive patients. Methods: the study included 29 ANCA positive patients (79.3% women and 20.7% men). The average age of women was 54.30 ± 15.45 years, the average age of men was 66.17 ± 14.13 years. ANCA existence in the serum was determined by indirect immunofluorescence whereas the serum levels of ET-1 (pg/ml) were determined by enzyme-linked immunosorbent assay (ELISA). The information about patients’ inflammatory markers (C-reactive protein (CRP), erythrocyte sedimentation rate, neutrophil number) was taken from the information system of the hospital. The statistical analysis was based on non-parametric methods, because data did not meet the assumption of normality. The results were considered as statistically significant, if p < 0.05. Results: the levels of ET-1 were found higher than the upper limit of recommended range (0.647 pg/ml) in all our patients. There was no significant difference in ET-1 concentration between gender or age the same as between different ANCA types or groups of diseases. We found a statistically significant and moderate relationship between ET-1 and CRP concentrations (r = 0.59, p = 0.005). This was the only one statistically significant linkage between ET-1 and inflammatory markers. Conclusions: the results suggest that ET-1 is closely related to pathogenesis of ANCA and has no significant effect on age or gender in ANCA positive patients. Increased ET-1 concentration may be found in several disease groups, and the severity of endothelial damage is independent of the ANCA serotype. In addition, results suggest that CRP and ET-1 synthesis could be also related. This shows that both ET- 1 and CRP may be used to monitor inflammation in ANCA positive patients. |
