Selected angiogenic factors in plasma of patients with lower limb symptomatic peripheral arterial disease: preliminary report.

AIM: The number of people suffering from atherosclerosis-related complications such as peripheral arterial disease (PAD) ­ including lower limbs PAD increases. Hypoxia and ischemia stimulate angiogenesis ­ a postnatal multistage process in which new blood vessels form and the Vascular Endothelial Growth Factor (VEGF-A) is the key proangiogenic factor whereas its soluble receptors type 1 and type 2 (sVEGFR-1, sVEGFR-2) are regarded as inhibitory factors. The aim of this study was to assess the concentrations of VEGF-A, sVEGFR-1 and sVEGFR-2 in plasma of patients with symptomatic lower extremity PAD compared with selected clinical parameters (Ankle-Brachial Index, distance in walking test) and severity of PAD (according to the Fontaine classification). METHODS: The study group included 46 patients suffering from symptomatic PAD with Fontaine class IIa-IV without any history of neoplastic disease. The control group consisted of 30 healthy non-smoking volunteers. The following parameters were determined: plasma concentrations of VEGF-A, its soluble receptors (sVEGFR-1, sVEGFR-2) using the ELISA method also VEGF-A and sVEGFR-1 quotient was calculated on the basis of mean concentrations in homogenous units (pg/mL). RESULTS: The study group revealed a statistically significant higher level of VEGF-A concentration when compared with the control group and statistically significant lower concentration of sVEGFR-2 in the study group. In the study group a statistically significant negative correlation between VEGF-A concentrations and the length of irrelative distance in walking test was observed. In the group of PAD a significantly higher VEGF-A/sVEGFR-1 ratio in comparison with the control group was obtained. Within the group of patient suffering from PAD there was noticed an increasing VEGF-A/sVEGFR-1 ratio in subsequent subgroups according to the Fontaine classification. CONCLUSION: The plasma concentrations of VEGF-A correlated with increased clinical symptoms of PAD in the walking test. The plasma VEGF-A/sVEGFR-1 ratio may be used as a useful ischemic marker in patients with PAD which should be tested and finally verified in large group of patients.

Plasminogen activators (t-PA and u-PA) and plasminogen activators inhibitors (PAI-1 and PAI-2) in some myeloproliferative syndromes.

INTRODUCTION: Clinical observations and laboratory data indicate that patients with myeloproliferative syndrome (MPS) have hemostasis disorders that manifest with haemorrhagic diathesis or thrombotic disease. The role of fibrinolytic system is not clear in the pathomechanism of the disorders. In the study we aimed to evaluate fibrinolysis system in blood plasma of the patients with selected myeloproliferative syndromes on the basis of examinations of plasminogen activators (tissue--t-PA and urokinase-type--u-PA) and type 1 and type 2 plasminogen activator inhibitors (PAI-1 and PAI-2). MATERIAL AND METHODS: Forty-two patients (F/M 28/14) aged 36-78 years (average age--54 years) were enrolled into the study. Among the patients were 20 individuals with chronic myeloid leukaemia (CML), 17 with essential thrombocytemia (ET) and 5 with myelofibrosis (MF) treated in Provincial Haematological Outpatient Clinic in Bydgoszcz. Forty healthy volunteers (F/M 30/10) aged 24-65 (average 53) were included in control group. In citrate venous blood, the following parameters were determined: concentrations of antigen t-PA, u-PA, PAI-1, PAI-2, concentration of plasmin-alpha-2-antiplasmin complexes (PAP) determined with the use of ELISA technique, PAI-1 activity with amidolytic method, euglobulin lysis time (ELT) according to Kowarzyk-Buluk and fibrinogen/fibrin degradation products (FDP) concentration with the use of Merskey's method. RESULTS: Performed evaluations show that besides normal ELT elevated concentrations of FDP and PAP complexes occur in the blood of patients with myeloproliferative syndromes (MPS.). In studied myeloproliferative syndromes, high concentration of PAI-1 Ag and very low activity of PAI-1 were observed. In the patients with MPS intensified plasminogenesis and increased fibrin degradation were demonstrated. The role of granulocyte elastase is considered in activation of fibrinolysis system.