Abstract |
The pathogenesis of abdominal aortic aneurysm (AAA) involves a central component of chronic inflammation which is predominantly mediated by myeloid cells. We hypothesized that the local inflammatory activity may be reflected in systemic alterations of neutrophil and monocyte populations as well as in soluble factors of myeloid cell activation and recruitment. To establish their marker potential, neutrophil and monocyte sub-sets were measured by flow cytometry in peripheral blood samples of 41 AAA patients and 38 healthy controls matched for age, sex, body mass index and smoking habit. Comparably, circulating factors reflecting neutrophil and monocyte activation and recruitment were assayed in plasma. Significantly elevated levels of CD16+ monocytes, activated neutrophils and newly released neutrophils were recorded for AAA patients compared with controls. In line, the monocyte chemoattractant C-C chemokine ligand 2 and myeloperoxidase were significantly increased in patients' plasma. The diagnostic value was highest for myeloperoxidase, a mediator which is released by activated neutrophils as well as CD16+ monocytes. Multivariable regression models using myeloid activation markers and routine laboratory parameters identified myeloperoxidase and D-dimer as strong independent correlates of AAA. These two biomarkers were combined to yield a diagnostic score which was subsequently challenged for confounders and confirmed in a validation cohort matched for cardiovascular disease. Importantly, the score was also found suited to predict rapid disease progression. In conclusion, D-dimer and myeloperoxidase represent two sensitive biomarkers of AAA which reflect distinct hallmarks ( thrombus formation and inflammation) of the pathomechanism and, when combined, may serve as diagnostic and prognostic AAA score warranting further evaluation.
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Authors | Branislav Zagrapan, Wolf Eilenberg, Suriya Prausmueller, Paimann Nawrozi, Katharina Muench, Sarah Hetzer, Vanessa Elleder, Renata Rajic, Felix Juster, Luca Martelanz, Hubert Hayden, Johannes Klopf, Cansu Inan, Peter Teubenbacher, Markus P Weigl, Patrick Kirchweger, Dietrich Beitzke, Bernd Jilma, Johann Wojta, Marc A Bailey, D Julian A Scott, Ihor Huk, Christoph Neumayer, Christine Brostjan |
Journal | Thrombosis and haemostasis
(Thromb Haemost)
Vol. 119
Issue 5
Pg. 807-820
(May 2019)
ISSN: 2567-689X [Electronic] Germany |
PMID | 30822810
(Publication Type: Journal Article)
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Copyright | Georg Thieme Verlag KG Stuttgart · New York. |
Chemical References |
- Chemokine CCL2
- Fibrin Fibrinogen Degradation Products
- fibrin fragment D
- Peroxidase
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Aortic Aneurysm, Abdominal
(diagnosis)
- Cell Separation
- Chemokine CCL2
(metabolism)
- Female
- Fibrin Fibrinogen Degradation Products
(metabolism)
- Flow Cytometry
- Humans
- Male
- Middle Aged
- Monocytes
(physiology)
- Neutrophils
(physiology)
- Peroxidase
(metabolism)
- Platelet Activation
- Predictive Value of Tests
- Prognosis
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