[A role of endothelin 1 in the pathogenesis of thromboangiitis obliterans (initital news)].

Background: [corrected] Etiology and pathogenesis of thromboangiitis obliterans, an uncommon disease, but connected with high risk of leg amputation, is still unknown. Genetic predisposition and inconvenient factors of environment, especially nicotine, could initiate an immunological process, which evokes endothelial dysfunction. In histological preparation inflammation and thrombus are observed. Endo-thelin-1 could affect these processes. It is a strong vasa-constrictor and has a wide spectrum of biological activity, often opposed to effect of prostacycline analogs. The aim of study was a role of endothelin-1, antielastin antibodies and selectin P, L, E in the pathogenesis Buerger's disease and influence of alprostadil on these parameters.
Material and Methods: We examined 10 patients with Buerger disease in the active phase, which were divided in two subgroups. Four persons with necrosis of toes were in the first subgroup, and six patients with rest pain but without trophic changes in the second subgroup. 13 healthy persons composed the control group. Index of antielastin antibodies, concentration of endotehlin-1, selectin P, L and E were measured in venous and arterial serum. These parameters by patients were determined twice: before and after 10-days treatment with alprostadil 20-40 microg per day. Concentration of endothelin-1, selectins and index antielastin antibodies were measured by enzyme-linked immuno-sorbent assay.
Results: We observe increase in endothelin-1 concentration by persons with necrosis of toes compared to patients without these changes (p=0.024) and to control (p=0.022). In the subgroup I index of antielastin antibodies IgA was higher than in control group (p=0.020). After alprostadil treatment endothelin-1 concentration, antielastin antibodies index was not statistically significant compared to results before treatment or control group. We observed correlation between concentration of endo-tehlin-1 before treatment and index of antielastin antibodies IgG (p=0.0475). We observed significant diffrance of concentration of selectin P, L and E compared to control (p=0.038). Especially we noticed higher concentration of selectin P (p=0.001) than in control group. The after treatment reduction of concentration was only for selectin L statistically significant (p=0.038).
Conclusion: 1. Plasma endothelin-1 level play a role in the exacerbation of clinical symtpoms of thromboangiitis obliterans. 2. Endothelial injury is connected with increase in concentration of selectin P in patient's serum. 3. Alprostadil didn't influence on concentration of endothelin-1 in these patients.