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Endothelial Microparticle as an early Marker of Endothelial Dysfunction in Patients with Essential Hypertension: A Pilot Study

  • Santhi SilambananEmail author
  • R. S. Hermes
  • Emmanuel Bhaskar
  • Sri Gayathri
Short Communication
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Abstract

Hypertension is a global health burden causing immense morbidity and mortality especially from the complications of end-organ damage. It is expected to affect 29% of the population by the year 2025. Hypertension is usually asymptomatic; it is diagnosed by a disease of exclusion. Numerous factors such as inflammation, oxidative stress, genetic predisposition etc. play roles in the pathogenesis of hypertension. Endothelial microparticles (EMPs) are released into the circulation with the onset of changes in endothelium, even before the release of other routine vascular endothelial markers. EMPs mediate inflammation, thrombosis and vasoconstriction of blood vessels in hypertensives. This pilot study was undertaken to assess whether EMPs are early markers of endothelial dysfunction in essential hypertensive patients. The study was conducted as a large case control study in which 525 individuals were involved. It consisted of three study groups: Group I: individuals with normal blood pressure (JNC8), group II: hypertensives without evidence of end-organ damage and group III: hypertensives with evidence of end-organ damage. Homocysteine, hsCRP, fibrinogen, eNOS, oxLDL and other markers were measured. For analysis of EMPs a subset of individuals are taken from each group. Control group of 10 individuals who had homocysteine level more than15μmol/L was taken as Group I. Another 10 individuals were taken randomly of five each from groups II and III. EMPs were analyzed by flow cytometry and were identified as CD31 +, CD42 − microparticles with diameters < 1.0 mm. There was significant increase in EMPs (p = 0.035) in hypertensive individuals with end organ damage. Measurement of EMPs in hypertensive individuals could help physicians in identifying and initiating therapeutic interventions at a very early stage of the disease, thus improving the quality of life.

Keywords

Hypertension Biomarkers of endothelium Endothelial dysfunction Endothelial microparticles Flow cytometry Homocysteine Atherosclerosis Endothelial injury Endorgan damage 

Abbreviations

EMPs

Endothelial microparticles

eNOS

Endothelial nitric oxide synthase

OxLDL

Oxidized low density lipoprotein

hsCRP

High sensitive C-reactive protein

MFI

Median fluorescence intensity

TF

Tissue factor

TNFα

Tumor necrosis factor alpha

PAI-1

Plasminogen activator inhibitor-1

LPS

Lipopolysaccharide

ROS

Reactive oxygen species

Notes

Acknowledgements

An oral presentation was done titled “Endothelial Microparticles as a marker of Endothelial Dysfunction in patients with Essential Hypertension” in AMBICON 2017—National conference held at Mysuru, by the Association of Medical Biochemists of India, from 17-11-2017 to 19-11-2017. The authors acknowledge Dr. Sathiasekaran, Professor in Community Medicine for his contribution in designing the study and analyzing the results.

Authors’ contributions

Hermes analyzed the samples for estimating biomarkers, Sri Gayathri helped in assessing endothelial microparticles by flow cytometry, Santhi Silambanan and Emmanuel Bhaskar were involved in writing the manuscript. All authors read and approved the final manuscript.

Funding

The work has been partly funded by Shri NPV Ramasamy Udayar Chancellor Research Fellowship. This fund was utilized for analysis of biological samples obtained from the participants.

Compliance with ethical standards

Conflict of interest

Santhi Silambanan was the brain behind this research and guided Hermes in conducting this research, which is in continuation of her Ph.D. work. Hermes has received the fund Shri NPV Ramasamy Udayar Chancellor Research Fellowship which supported part of this research. Emmanuel Bhaskar was a member of the research advisory committee, whose advice contributed to the results and discussion of the article. Sri Gayathri helped in doing the analysis of EMPs by flow cytometry in Central Research Facility of our Institute. The authors declare that they have no conflict of interest.

Ethics approval and consent to participate

This study has been carried out in accordance with the Declaration of Helsinki and ethics clearance was obtained from Institutional Ethics Committee (IEC-NI/14/JUN/40/35). Written informed consent was obtained from the participants before being enrolled in the study. Only participants who volunteered to take part in the study were included.

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Copyright information

© Association of Clinical Biochemists of India 2019

Authors and Affiliations

  1. 1.Department of BiochemistrySri Ramachandra Institute of Higher Education and Research (Deemed to be University)PorurIndia
  2. 2.Department of General Medicine, Sri Ramachandra Institute of Higher Education and ResearchPorurIndia
  3. 3.Department of Pathology, Sri Ramachandra Institute of Higher Education and ResearchPorurIndia

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