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Page 37
May 24-25, 2018
London, UK
Vascular Surgery 2018
3 rd Edition of World Congress & Exhibition on
Vascular Surgery
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
Background: The pathogenesis of abdominal aortic aneurysm
(AAA) involves a central component of chronic inflammation
which is predominantly mediated by myeloid cells. Both,
neutrophils and monocytes are recruited to the AAA wall and
intraluminal thrombus and contribute to vessel destruction by
the release of proteases and reactive oxygen species.
Purpose: We hypothesized that the local activation of myeloid
cells may be reflected in systemic alterations of neutrophil
and monocyte populations as well as in associated soluble
factors which might serve as biomarkers to diagnose the often-
asymptomatic disease.
Methods: The methods of this study were to establish their
diagnostic marker potential, neutrophil and monocyte subsets
were measured by flow cytometry in peripheral blood samples of
41 AAA patients and 38 healthy controls matched for age, sex,
body mass index and smoking habit. Comparably, circulating
factors relating to myeloid cell activation and recruitment were
assayed in plasma by multicytokine array and ELISA.
Results: Significantly elevated levels of CD16+ monocytes,
activated neutrophils and newly released neutrophils were
recorded for AAA patients compared to controls. In line, the
monocyte chemoattractant protein 1 and myeloperoxidase
were significantly increased in patients´ plasma. The diagnostic
value was highest for myeloperoxidase, a mediator which is
released by activated neutrophils as well as CD16+ monocytes.
Comparison of the investigated myeloid factors with established
AAA parameters by multivariable logistic regression identified
myeloperoxidase and D-dimer as highly significant, independent
variables. These two biomarkers were combined to yield a
potent diagnostic score which was subsequently confirmed in
a validation cohort.
Conclusions: Based on a comprehensive comparison of
myeloid cell activation parameters, plasma myeloperoxidase
was identified as the most potent AAA biomarker. Since D-dimer
and myeloperoxidase represent two sensitive markers of AAA
which reflect distinct components of the AAA pathomechanism
(thrombus formation and inflammation) they may be combined
to yield an improved diagnostic score.
Recent Publications
1. Takagi H, Manabe H, Kawai N, et al. (2009) Plasma
fibrinogen and D-dimer concentrations are associated
with the presence of abdominal aortic aneurysm: a
systematic review and meta-analysis. European Journal
of Vascular and Endovascular Surgery 38:273-277.
2. Sidloff D A, Stather P W, Choke E, et al. (2014) A
systematic review and meta-analysis of the association
between markers of hemostasis and abdominal aortic
aneurysm presence and size. Journal of Vascular
Surgery 59:528-535.
3. Golledge J, Muller R, Clancy P, et al. (2011) Evaluation of
the diagnostic and prognostic value of plasma D-dimer
for abdominal aortic aneurysm. European Heart Journal
32:354-364.
4. Houard X, Touat Z, Ollivier V, et al. (2009) Mediators
of neutrophil recruitment in human abdominal aortic
aneurysms. Cardiovascular Research 82:532-541.
5. Dale Ma, Ruhlman M K and Baxter B T (2015)
Inflammatory Cell Phenotypes in AAAs. Arteriosclerosis,
Thrombosis, and Vascular Biology 35:1746-1755
Biography
Branislav Zagrapan is pursuing his PhD on the topic of molecular and cellular
diagnostic and prognostic markers of abdominal aortic aneurysms. He is a
Pathologist in training at the Academic Teaching Hospital Feldkirch, Austria
An improved diagnostic score for abdominal aortic aneurysms
based on a comprehensive analysis of myeloid cell parameters
Branislav Zagrapan, Christoph Neumayer, Wolf Eilenberg, Katharina Muench,
Renata Rajic, Patrick Kirchweger, Bernd Jilma, Christoph Domenig, Ihor Huk,
Georg Heinze and Christine Brostjan
Medical University of Vienna, Austria
Branislav Zagrapan et al., J Vasc Endovasc Therapy 2018, Volume 3
DOI: 10.21767/2573-4482-C1-002