Circulating endothelial cells as potential diagnostic biomarkers in primary central nervous system vasculitis
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Circulating endothelial cells as potential diagnostic biomarkers in primary central nervous system vasculitis. / Deb-Chatterji, Milani; Gerdes, Stefan; Heeren, Meike; Lambrecht, Jürgen; Worthmann, Hans; Goldbecker, Annemarie; Tryc, Anita Blanka; Lovric, Svjetlana; Schulz-Schaeffer, Walter; Brandis, Almuth; Dengler, Reinhard; Weissenborn, Karin; Haubitz, Marion.
in: J NEUROL NEUROSUR PS, Jahrgang 84, Nr. 7, 07.2013, S. 732-4.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Circulating endothelial cells as potential diagnostic biomarkers in primary central nervous system vasculitis
AU - Deb-Chatterji, Milani
AU - Gerdes, Stefan
AU - Heeren, Meike
AU - Lambrecht, Jürgen
AU - Worthmann, Hans
AU - Goldbecker, Annemarie
AU - Tryc, Anita Blanka
AU - Lovric, Svjetlana
AU - Schulz-Schaeffer, Walter
AU - Brandis, Almuth
AU - Dengler, Reinhard
AU - Weissenborn, Karin
AU - Haubitz, Marion
PY - 2013/7
Y1 - 2013/7
N2 - OBJECTIVE: Histological evidence is considered the only proof of primary central nervous system vasculitis (PCNSV). However, brain biopsy is often omitted or delayed because of the invasiveness and possible complications of the procedure. Circulating endothelial cells (CEC) were shown to be elevated in patients with active antineutrophil cytoplasmic antibody-associated vasculitis. We hypothesise that CEC are also elevated in patients with active PCNSV and may contribute to the diagnosis.METHODS: CEC were assessed in 18 patients, 3 of whom had biopsy-proven PCNSV and 15 clinical, cerebrospinal fluid and imaging data, highly suggestive of PCNSV. In 3 of these 15 patients CEC assessment was performed after initiation of successful immunosuppressive therapy. CEC numbers of all patients were compared to those of 16 healthy volunteers and 123 subjects with cerebrovascular risk factors and/or ischaemic stroke, who had been studied in our group before. CEC were assessed by immunomagnetic isolation from peripheral blood.RESULTS: In patients with proven and suspected active PCNSV, CEC were extremely elevated (>400 cells/ml in most of the patients) and significantly higher than in healthy and disease controls (p≤0.01 for each group). CEC significantly decreased with immunosuppressive treatment.CONCLUSIONS: For the first time it is shown that CEC are significantly elevated in patients with active PCNSV in contrast to other pathologies associated with brain infarction and correlate with disease activity. Sensitivity and specificity of the method for diagnosing PCNSV and the use of the method for treatment monitoring should be addressed in future prospective studies with a larger patient group.
AB - OBJECTIVE: Histological evidence is considered the only proof of primary central nervous system vasculitis (PCNSV). However, brain biopsy is often omitted or delayed because of the invasiveness and possible complications of the procedure. Circulating endothelial cells (CEC) were shown to be elevated in patients with active antineutrophil cytoplasmic antibody-associated vasculitis. We hypothesise that CEC are also elevated in patients with active PCNSV and may contribute to the diagnosis.METHODS: CEC were assessed in 18 patients, 3 of whom had biopsy-proven PCNSV and 15 clinical, cerebrospinal fluid and imaging data, highly suggestive of PCNSV. In 3 of these 15 patients CEC assessment was performed after initiation of successful immunosuppressive therapy. CEC numbers of all patients were compared to those of 16 healthy volunteers and 123 subjects with cerebrovascular risk factors and/or ischaemic stroke, who had been studied in our group before. CEC were assessed by immunomagnetic isolation from peripheral blood.RESULTS: In patients with proven and suspected active PCNSV, CEC were extremely elevated (>400 cells/ml in most of the patients) and significantly higher than in healthy and disease controls (p≤0.01 for each group). CEC significantly decreased with immunosuppressive treatment.CONCLUSIONS: For the first time it is shown that CEC are significantly elevated in patients with active PCNSV in contrast to other pathologies associated with brain infarction and correlate with disease activity. Sensitivity and specificity of the method for diagnosing PCNSV and the use of the method for treatment monitoring should be addressed in future prospective studies with a larger patient group.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Biomarkers
KW - Biopsy
KW - Brain
KW - Brain Ischemia
KW - Cerebral Infarction
KW - Endothelial Cells
KW - Female
KW - Humans
KW - Immunosuppressive Agents
KW - Male
KW - Middle Aged
KW - Monitoring, Physiologic
KW - Prospective Studies
KW - Risk Factors
KW - Stroke
KW - Treatment Outcome
KW - Vasculitis, Central Nervous System
KW - Journal Article
U2 - 10.1136/jnnp-2012-303335
DO - 10.1136/jnnp-2012-303335
M3 - SCORING: Journal article
C2 - 23243263
VL - 84
SP - 732
EP - 734
JO - J NEUROL NEUROSUR PS
JF - J NEUROL NEUROSUR PS
SN - 0022-3050
IS - 7
ER -