1. ADMA as a possible marker of endothelial damage. A study in young asymptomatic patients with cerebral small vessel disease
- Author
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Gian Luigi Gigli, Mariarosaria Valente, Nova Sanvilli, Francesco Curcio, Adriana Cifù, Rossana Domenis, Annacarmen Nilo, Roberta Giacomello, Riccardo Garbo, M. Fabris, Francesco Janes, and Maria Elena Pessa
- Subjects
Adult ,Male ,Aging ,medicine.medical_specialty ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Arginine ,Thrombophilia ,Gastroenterology ,Asymptomatic ,Article ,Pathogenesis ,Endothelial activation ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Coagulopathy ,medicine ,Humans ,Cognitive Dysfunction ,Endothelial dysfunction ,lcsh:Science ,Stroke ,Aged ,Multidisciplinary ,business.industry ,lcsh:R ,Confounding ,Brain ,Endothelial Cells ,Diagnostic markers ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Cerebral Small Vessel Diseases ,Female ,lcsh:Q ,medicine.symptom ,business ,Biomarkers ,030217 neurology & neurosurgery - Abstract
Sporadic small vessel disease (SVD) has high prevalence in aging population and stroke patients, but also in younger asymptomatic subjects. In this last group it can represents a prelude to stroke and cognitive impairment. Still nowadays, its pathogenesis is unclear. 35 consecutive patients with SVD at brain MRI and 35 age- and sex-matched controls, between January 2016 and February 2018, underwent an extended screening for thrombophilia, autoimmunity and evaluated levels of blood markers of inflammation and endothelial activation. Asymmetric DiMethyl Arginine (ADMA) levels proved higher in patients (70.44 ± 36.25 ng/ml vs. 46.58 ± 30.67 ng/ml; p = 0.004), also after controlling for confounding factors. ADMA levels showed positive correlation with Fazekas score (r = 0.304; p = 0.01). ROC curve analysis showed a moderate accuracy in discriminating patients and controls (AUC = 0.70; CI 0.57–0.82; p = 0.004): a cut-off of 46 ng/ml is associated with 80% sensitivity, but limited (54%) specificity. Higher ADMA levels characterize selected subjects with sporadic SVD, asymptomatic for vascular diseases and without latent inflammatory conditions or coagulopathy. This reinforces the hypothesis of the key role of endothelial dysfunction in SVD. Further studies should explore the cause-effect relationship between ADMA pathway and SVD.
- Published
- 2019
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