Procoagulant Membrane Microparticles Correlate with the Severity of Pulmonary Arterial Hypertension

• Published in: American journal of respiratory and critical care medicine Vol. 177; no. 5; pp. 536 - 543
• Main Authors: Bakouboula, Babe, Morel, Olivier, Faure, Antoine, Zobairi, Fatiha, Jesel, Laurence, Trinh, Annie, Zupan, Michel, Canuet, Matthieu, Grunebaum, Lelia, Brunette, Agnes, Desprez, Dominique, Chabot, Francois, Weitzenblum, Emmanuel, Freyssinet, Jean-Marie, Chaouat, Ari, Toti, Florence
• Format: Journal Article
• Language: English
• Published: New York, NY Am Thoracic Soc 01.03.2008; American Lung Association; American Thoracic Society
• Subjects: Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antigens, CD - blood; Biological and medical sciences; Blood Coagulation - physiology; Blood Gas Analysis; Blood platelets; C-Reactive Protein - analysis; Cardiac catheterization; Cell growth; Chemokine CCL2 - blood; Chemokine CCL5; Disease; Endoglin; Endothelium; Endothelium, Vascular - pathology; Endothelium, Vascular - physiopathology; Female; Heart; Hemodynamics; Humans; Hypertension, Pulmonary - blood; Hypertension, Pulmonary - physiopathology; Inflammation - blood; Intensive care medicine; Intubation; Lung - blood supply; Male; Medical sciences; Microcirculation; Middle Aged; Nitric oxide; Particle Size; Plasma; Pneumology; Proteins; Pulmonary arteries; Pulmonary hypertension; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases; Receptors, Cell Surface - blood; Severity of Illness Index; Thromboplastin - analysis; Vascular Cell Adhesion Molecule-1 - blood; Veins & arteries; Intensive care; VCAM-1; Respiratory disease; Tissue factor; Cardiovascular disease; endoglin; Pulmonary hypertension; Resuscitation; Endothelium
• ISSN: 1073-449X; 1535-4970; 1535-4970
• DOI: 10.1164/rccm.200706-840OC

Procoagulant microparticles constitute valuable hallmarks of cell damage. Microparticles also behave as cellular effectors. We hypothesized that the extent of the vascular cell damage measured by circulating microparticles could be related to the severity of pulmonary arterial hypertension (PAH). Circulating biomarkers of vascular damage and cell activation were measured in blood samples from 20 patients with PAH. Samples were withdrawn from occluded pulmonary artery and jugular vein. Peripheral venous blood samples were obtained in 23 control subjects. The microparticle procoagulant abilities were quantified by functional prothrombinase and tissue factor assays and their cellular origin was determined. Soluble vascular cellular adhesion molecule-1 and proinflammatory markers, such as monocyte chemoattractant protein-1 and highly specific C-reactive protein, were elevated in patients with PAH compared with control subjects. Microparticles bearing active tissue factor and CD105 (endoglin) were also elevated in patients with PAH compared with control subjects (29 +/- 13 vs. 16 +/- 6 fmol/L, P < 0.001, and 1.10 +/- 0.46 vs. 0.49 +/- 0.33 nmol/L phosphatidylserine equivalent, P < 0.001, respectively). A further increase in endothelium-derived CD105 microparticles was observed in pulmonary arterial blood compared with venous blood in patients with PAH (1.73 +/- 0.77, P = 0.038). Microparticles bearing active tissue factor were at a higher level in patients in functional class III and IV and who were walking fewer than 380 m with the six-minute-walk test. Circulating markers of endothelium damage, proinflammatory markers, and cell stimulation estimated with circulating microparticles appear to be valuable tools in determining the severity of PAH.