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[Measurement of biological parameters of endothelial origin: value in human pathology]
1Laboratoire d'hématologie et d'immuno-hématologie, UFR de Pharmacie, Marseille, France.
Endothelial damage is a major factor in the pathogenesis of vascular diseases, but routine investigations of vascular lesions are hampered due to endothelial cell characteristics such as limited accessibility, intrinsic immunological and functional heterogeneity as well as the lack of specific markers. The most frequently used markers are soluble substances, found in plasma, such as the von Willebrand factor, thrombomodulin, tissue plasminogen activator and its inhibitor, or soluble adhesion molecules. Their easy evaluation in semi-routine tests gives access to a global exploration of functional alterations and of abnormal states of endothelial activation. Immunohistological techniques using monoclonal antibodies allow to study the expression of membrane antigens and permit direct and specific investigation of activation states of endothelium. However, the invasive and traumatic characteristics of sampling procedure considerably limit the utilization of immunohistological techniques for clinical applications. Detection in the peripheral blood of endothelial cells detached from vessels could be a good marker for desquamative lesions. From a simple blood sample, it is now possible, using specific immunodetection techniques to isolate circulating endothelial cells present in low numbers in various pathologies associated with vascular injury. Although significant modifications of these markers have been found associated with endothelial alterations, prospective clinical studies are still necessary to demonstrate their clinical relevance in vascular diseases.
Endothelial damage is a major factor in the pathogenesis of vascular diseases, but routine investigations of vascular lesions are hampered due to endothelial cell characteristics such as limited accessibility, intrinsic immunological and functional heterogeneity as well as the lack of specific markers. The most frequently used markers are soluble substances, found in plasma, such as the von Willebrand factor, thrombomodulin, tissue plasminogen activator and its inhibitor, or soluble adhesion molecules. Their easy evaluation in semi-routine tests gives access to a global exploration of functional alterations and of abnormal states of endothelial activation. Immunohistological techniques using monoclonal antibodies allow to study the expression of membrane antigens and permit direct and specific investigation of activation states of endothelium. However, the invasive and traumatic characteristics of sampling procedure considerably limit the utilization of immunohistological techniques for clinical applications. Detection in the peripheral blood of endothelial cells detached from vessels could be a good marker for desquamative lesions. From a simple blood sample, it is now possible, using specific immunodetection techniques to isolate circulating endothelial cells present in low numbers in various pathologies associated with vascular injury. Although significant modifications of these markers have been found associated with endothelial alterations, prospective clinical studies are still necessary to demonstrate their clinical relevance in vascular diseases.