Endothelial Microparticles and the Diagnosis of the Vasculitides

Brogan, Paul A.; Dillon, Michael J.

doi:10.2169/internalmedicine.43.1115

Cited by 35 publications

(29 citation statements)

References 35 publications

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“…Although not a routine investigative procedure, the recently developed measurements of circulating endothelial microparticles and circulating endothelial cells may prove helpful in demonstrating the presence of active vasculitic disease as well as throwing light on the mechanisms involved [56–62]. Furthermore, measurement of circulating endothelial progenitor cells may be helpful in pointing to evidence of a repair process being under way in the recovery phase of disease [61, 63].…”

Section: Polyarteritis Nodosamentioning

confidence: 99%

Medium-size-vessel vasculitis

Dillon¹,

Eleftheriou²,

Brogan³

2009

Pediatr Nephrol

110

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Medium-size-artery vasculitides do occur in childhood and manifest, in the main, as polyarteritis nodosa (PAN), cutaneous PAN and Kawasaki disease. Of these, PAN is the most serious, with high morbidity and not inconsequential mortality rates. New classification criteria for PAN have been validated that will have value in epidemiological studies and clinical trials. Renal involvement is common and recent therapeutic advances may result in improved treatment options. Cutaneous PAN is a milder disease characterised by periodic exacerbations and often associated with streptococcal infection. There is controversy as to whether this is a separate entity or part of the systemic PAN spectrum. Kawasaki disease is an acute self-limiting systemic vasculitis, the second commonest vasculitis in childhood and the commonest cause of childhood-acquired heart disease. Renal manifestations occur and include tubulointerstitial nephritis and renal failure. An infectious trigger and a genetic predisposition seem likely. Intravenous immunoglobulin (IV-Ig) and aspirin are effective therapeutically, but in resistant cases, either steroid or infliximab have a role. Greater understanding of the pathogenetic mechanisms involved in these three types of vasculitis and better long-term follow-up data will lead to improved therapy and prediction of prognosis.

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Section: Polyarteritis Nodosamentioning

confidence: 99%

Medium-size-vessel vasculitis

Dillon¹,

Eleftheriou²,

Brogan³

2009

Pediatr Nephrol

110

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“…Studies of endothelial function have demonstrated profound impairment during active disease which does not normalize in remission, suggesting both a vascular effect of incomplete disease control and a risk factor for later cardiovascular events 63 . Circulating endothelial cells, endothelial microparticles and other endothelial markers, such as von Willebrand factor, are elevated during active vasculitis and have potential as indicators of vascular health 64–66 …”

Section: Future Therapies Of Vasculitismentioning

confidence: 99%

Review article: Progress of treatment in ANCA‐associated vasculitis

Jayne

2009

Nephrology

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This study reports on innovations in the field of, and current approaches to, the therapy of ANCA-associated vasculitis (AAV). Randomized clinical trials and prospective open label trial of newer therapies performed in the last 15 years in Wegener's granulomatosis and microscopic polyangiitis or both (AAV) were reviewed. Although cyclophosphamide remains the favoured immunosuppressive for remission induction, the use of alternative immunosuppressives and of intravenous pulsed administration have reduced cyclophosphamide exposure and are likely to increase the safety of treatment. Mycophenolate mofetil, leflunomide and deoxyspergualin are newer immunosuppressive drugs which have been evaluated in AAV, while tumpur necrosis factor, alemtuumab and rituximab are 'biologic' agents that have received attention. There is insufficient study of the dosing of glucocorticoids. Plasma exchange is indicated for severe renal vasculitis. Outcomes for elderly patients presenting with severe renal impairment are often poor despite optimal therapy. The development of collaborative networks in Europe and the USA has facilitated the conduct of larger randomized controlled trials. These have led to consensus recommendations on how AAV should be treated. Many newer agents are currently under evaluation which have the potential to improve AAV outcomes in the future.

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“…For example, the abundance of endothelial and platelet microvesicles was indicated to correlate more specifically with thrombotic manifestations of antiphospholipid syndrome than antiphospholipid antibody levels alone and might thus provide an additional information for defining the disease [7,8,23]. Also detection of microvesicles could be used in conjunction with perceived gold-standards (tissue biopsy, angiography) for the diagnosis of active vasculitis [24] and for assessing the activity of rheumatoid arthritis [25].…”

Section: Introductionmentioning

confidence: 99%

Blood and Synovial Microparticles as Revealed by Atomic Force and Scanning Electron Microscope

Junkar¹,

Šuštar²,

Frank³

et al. 2009

TOAUTOJ

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Abstract:Microvesicles which are pinched off the cell membrane can be considered extracellular organelles which mediate interaction between distal cells. They were suggested to play an important role in many diseases including autoimmune disorders, however, standard methods for their assessment have not yet been decided upon while their clinical relevance and the underlying mechanisms are yet unclear. We present a pilot study results involving atomic force microscope (AFM) and scanning electron microscope (SEM) images of the material isolated from peripheral blood of healthy donors and from synovial fluid of patients with psoriatic arthritis and rheumatoid arthritis, which is expected to contain microvesicles. Micrographs reveal in the samples isolated from blood the presence of globular and tubular structures which are most probably microvesicles while the identity of grain-like structures isolated from synovial fluid remains obscure. To the best of our knowledge the AFM and SEM images of the material isolated from synovial fluid are presented for the first time.

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Endothelial Microparticles and the Diagnosis of the Vasculitides

Cited by 35 publications

References 35 publications

Medium-size-vessel vasculitis

Medium-size-vessel vasculitis

Review article: Progress of treatment in ANCA‐associated vasculitis

Blood and Synovial Microparticles as Revealed by Atomic Force and Scanning Electron Microscope

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