Avaliação das células endoteliais circulantes na trombose venosa profunda : pacientes e modelo animal / Evaluation of the circulating endothelial cell in deep venous thrombosis : patients and animal model

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

Endothelial cells participate in hemostasia and have pro and anti –thrombotic effects which can be stimulated by an endothelial lesion. The presence of endothelial cells in circulation can be considered a novel marker of vascular integrity, as described in several pathologies, such as: cardiovascular disease, infectious disease, immune diseases, transplants, and sickle cell anemia. The aims of our study were to: standardize the identification and quantification of circulating endothelial cells (CECs) and progenitor endothelial cells (EPCs) in a group of patients with Deep Vein Thrombosis (DVT) at diagnosis (acute, 1st collection) and after a minimum of six months (2nd collection), in a group with chronic DVT and in a control group; standardize an animal model with DVT induced by endothelial lesion in order to evaluate CECs and EPCs in peripheral blood and in venous thrombosis. The group of DVT was composed of 9 patients [F: 7; M: 2; 45 years old (y.o.) (26 – 54 y.o.)], of which six individuals were recruited for the 2nd collection [F: 5; M: 1; 47.5 y.o. (27 – 55 y.o.)]; in the chronic DVT group 10 patients were included [F: 6; M: 4; 44.5 y.o. (28 – 56 y.o.)]; and in the control group 11 volunteers were included [F: 9; M: 2; 29 y.o. (21 – 52 y.o.)]. The identification of CECs and EPCs in peripheral blood was carried out by flow cytometry. DVT was induced in the animal model by endothelial lesion using a FeCl3 solution at 15%. After DVT induction, CECs and EPCs were evaluated in peripheral blood at: 15 minutes, 30 minutes, 45 minutes, 1 hour, 24 hours, 48 hours and 72 hours. The venous thrombus formed in the inferior cava vein (ICV) was evaluated using Verhoff van Gienson stain and the presence of CECs and EPCs was evaluated using immunofluorescence. There was a statistical difference in the number of CECs (P=0.001, CD31+CD144+CD45dimCD133-; P<0.001, CD31+CD146+CD45dimCD133-; P=0.002, CD31+VEGFR2+CD45dimCD133-) between the groups studied, with a significant increase in acute DVT patients. The chronic DVT and 2nd collection DVT groups demonstrated a significant increase in CECs in relation to the controls. There was no statistical difference in the number of EPCs (CD34+VEGFR2+CD45dimCD133-) among the groups studied, however an increase in the acute DVT group was observed. In the animal model, total ICV occlusion was observed between 15 minutes and 1 hour. After 24 hours a progressive decrease in the area of the formed thrombus occurred [85.4% (24h); 65.4% (48h); 51.3% (72h)], and no CECs or CEPs were observed. After 48hours, there was a significant increase in CECs and EPCs in peripheral blood when compared to other periods studied (P=0.001, Sca1-VEGFR2+ CD45dim; P=0.004, CD34-VEGFR2+CD45dim; P<0.001, Sca1+VEGFR2+CD45dim; P<0.001, CD34+VEGFR2+CD45dim). The results observed in mice and human beings suggest that EPCs can be recruited to circulation from the bone marrow, participating in a process of endothelial repair. The increase of CECs during the phase when the re-channeling process begins in the animal model, suggests that despite the initial endothelial lesion, CECs are liberated when the flow is reestablished. In the present study we concluded that CECs can represent a vascular damage marker.

ASSUNTO(S)

célula endotelial trombose venosa modelo experimental endothelial cell deep venous thrombosis experimental model

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