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Assessing Therapeutic Angiogenesis in a Murine Model of Hindlimb Ischemia
Published on: June 8, 2019
Higher Levels of Cytokines in Patients with Chronic Limb-Threatening Ischemia
Joana Ferreira1, Susana Roque2, Adhemar Longatto-Filho3
1Vascular Surgery Department - Fisiologia e Cirurgia, Centro Hospitalar Universitário de São João, Porto, Portugal; Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; Centro Académico Hospital da Senhora da Oliveira, Guimarães, Portugal; ICVS/3B's - PT Government Associated Laboratory, Braga/Guimarães, Portugal.
Insights
Patients with chronic limb-threatening ischemia (CLTI) exhibit elevated serum inflammatory cytokines compared to those with claudication. These cytokine levels may influence patient prognosis and amputation risk in peripheral arterial disease (PAD).
Area of Science:
- Vascular Surgery
- Immunology
- Biochemistry
Background:
- Inflammation plays a crucial role in the development and progression of peripheral arterial disease (PAD).
- Understanding the role of specific cytokines in PAD can potentially improve patient outcomes.
- This study investigates cytokine profiles in PAD patients with varying disease severity.
Purpose of the Study:
- To compare serum cytokine levels between patients with claudication and those with chronic limb-threatening ischemia (CLTI).
- To assess the relationship between cytokine levels and the risk of death or amputation in PAD patients.
Main Methods:
- An observational, single-center, prospective study included 119 PAD patients (January 2018 - July 2022).
- Exclusion criteria targeted conditions affecting body composition or inflammatory state.
- Serum levels of 27 cytokines were measured at baseline using ELISA.
Main Results:
- Patients with CLTI (n=54) showed significantly higher serum levels of 11 cytokines compared to claudication patients (n=65).
- Elevated cytokines in CLTI patients included IL-6, IL-8, and TNF-α.
- Higher FGF-basic levels were observed in CLTI patients who underwent major amputation (P=0.001).
Conclusions:
- Chronic limb-threatening ischemia (CLTI) is associated with a heightened systemic inflammatory response, indicated by elevated cytokine levels.
- Specific inflammatory cytokines may serve as prognostic markers for PAD progression, amputation, and mortality.
- Further research into cytokine modulation could offer novel therapeutic strategies for PAD.
Background:
Inflammation is a key element in the initiation and progression of peripheral arterial disease (PAD). Understanding the impact of inflammatory molecules, as cytokines in PAD could help us to improve the prognosis of these patients. The main goal of this study was to compare the serum level of cytokines between patients with claudication to those with chronic limb-threatening ischemia (CLTI). The second objective was to evaluate the relationship between the levels of cytokines and death or amputation rate.
Methods:
An observational, single-center, and prospective study was conducted from January 2018 to July 2022. The study was approved by the ethical commission of the Local Hospital (75/2017). Patients with PAD, suggested by the clinical history and objective examination and confirmed with ankle-brachial index, attending vascular surgery consultations of the first author were included. The following exclusion criteria were applied: i) bedridden individuals or subjects who refused to participate in the protocol; ii) diseases responsible for body composition changes or proinflammatory state; iii) recent diet change, iv) active malignancy, v) autoimmune disease, vi) active infection, vii) chronic renal failure (glomerular filtration rate <30 mL/min/1.73 m2), or viii) heart failure in the past 3 months. This cohort was observed at admission, 3, 6, and 12 months. A panel of 27 cytokines was determined with ELISA, at baseline.
Results:
We included 119 subjects (mean age: 67.58 ± 9.60 years old; 79.80% males), 65 patients with claudication and 54 with CLTI. From the 27 cytokines analyzed, patients with CLTI, when compared to those with claudication, had a higher serum level of 11 cytokines: IL1ra, IL-6, IL-8, IL12 p70, G-CSF, IP-10, MCP-1, MIP-1α, PDGF-β, RANTES, and TNF-α. From the group of patients with CLTI those who underwent a major amputation had a higher serum level of FGF-basic [median = 49.04; interquartile range = 37.03-52.49; versus median = 33.04; interquartile range = 28.60-38.98; P = 0.001].
Conclusions:
Patients with CLTI have higher serum level of inflammatory cytokines, which may have role in the prognosis of these patients.
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