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Updated: Jun 27, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Endothelial dysfunction and complement activation are independently associated with disease duration in patients with
Panagiotis Dolgyras1, Panagiota Anyfanti1, Antonios Lazaridis1
13rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Insights
Systemic vasculitis patients show early signs of endothelial dysfunction and complement activation, even without cardiovascular disease. Biomarkers like EMVs and C5b-9 may help detect these issues early in systemic vasculitis (SV) patients.
Area of Science:
- Immunology
- Cardiovascular Medicine
- Autoimmune Diseases
Background:
- Systemic vasculitis (SV) is linked to high cardiovascular mortality.
- Endothelial dysfunction is a key factor in SV's vascular damage and cardiovascular risk.
- Complement activation plays a significant role in Anti-Neutrophilic Cytoplasmic Autoantibody-associated vasculitis (AAV).
Purpose of the Study:
- To simultaneously assess biomarkers of endothelial dysfunction and complement activation in systemic vasculitis.
- To investigate the relationship between these biomarkers and cardiovascular risk factors in SV patients.
- To explore the potential of these biomarkers for early detection in SV.
Main Methods:
- Measured circulating endothelial microvesicles (EMVs) and soluble complement components (C5b-9, C1q, Bb) in 30 SV patients and 30 matched controls.
- Controlled for cardiovascular risk factors like hypertension, diabetes, smoking, and dyslipidemia.
- Analyzed associations between biomarkers, disease duration, and disease activity.
Main Results:
- SV patients had elevated EMVs and higher levels of C5b-9 and C1q compared to controls.
- Both EMVs and C5b-9 were independently associated with disease duration in SV patients.
- No significant association was found between these biomarkers and current disease activity.
Conclusions:
- Systemic vasculitis patients exhibit impaired endothelial function and complement activation, detectable via accessible biomarkers even without overt cardiovascular disease.
- Endothelial microvesicles (EMVs) and soluble complement components (C5b-9, C1q) show promise as early biomarkers in clinical practice for SV.
- Further research is needed to validate the predictive value of these biomarkers for future cardiovascular disease in SV patients.
Objectives:
Systemic vasculitis is a heterogenous group of autoimmune diseases characterized by enhanced cardiovascular mortality. Endothelial dysfunction is associated with accelerated vascular damage, representing a core pathophysiologic mechanism contributing to excess CV risk. Recent studies have also shown that complement activation holds significant role in the pathogenesis of Anti-Neutrophilic Cytoplasmic Autoantibody (ANCA) -associated vasculitis (AAV). Given the potential crosstalk between the endothelium and complement, we aimed to assess, for the first time simultaneously, easily accessible biomarkers of endothelial dysfunction and complement activation in SV.
Methods:
We measured circulating endothelial microvesicles (EMVs) and soluble complement components representative of alternative, classical and terminal activation (C5b-9, C1q, Bb fragments, respectively) in a meticulously selected group of patients with systemic vasculitis, but without cardiovascular disease. Individuals free from systemic diseases, who were matched with patients for cardiovascular risk factors(hypertension, diabetes, smoking, dyslipidemia), comprised the control group.
Results:
We studied 60 individuals (30 in each group). Patients with systemic vasculitis had elevated EMVs, higher levels of C5b-9 [536.4(463.4) vs 1200.94457.3), p = 0.003] and C1q [136.2(146.5 vs 204.2(232.9), p = 0.0129], compared to controls [232.0 (243.5) vs 139.3(52.1), p < 0.001]. In multivariate analysis both EMVs and C5b-9 were independently associated with disease duration (p = 0.005 and p = 0.004 respectively), yet not with disease activity.
Conclusion:
Patients with systemic vasculitis exhibit impaired endothelial function and complement activation, both assessed by easily accessible biomarkers, even in the absence of cardiovascular disease manifestations. EMVs and soluble complement components such as C5b-9 and C1q could be used as early biomarkers of endothelial dysfunction and complement activation, respectively, in clinical practice during the course of SV, yet their predictive value in terms of future cardiovascular disease warrants further verification in appropriately designed studies.
