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Circulating Endothelial Microparticles as a Measure of Early Lung Destruction in Cigarette Smokers
Abstract
Rationale: There is increasing evidence that emphysema is associated with primary loss of pulmonary capillary endothelium. Plasma levels of endothelial microparticles (EMPs), small vesicles released from activated or apoptotic endothelial cells, are elevated in vascular-related disorders. Objectives: To evaluate whether plasma EMP levels are elevated in smokers with early lung destruction as assessed by normal spirometry but reduced diffusing capacity of the lung for carbon monoxide (Dlco). Methods: Lung health was assessed by pulmonary function tests (PFTs: spirometry, total lung capacity, Dlco) and chest X-ray; smoking status was assessed by urine nicotine and cotinine. EMP levels (CD42b−CD31+ microparticles) were quantified as activated or apoptotic. The initial cohort (n = 92) included healthy nonsmokers (normal PFTs), healthy smokers (normal PFTs), and smokers with early evidence of lung destruction (normal spirometry, low Dlco). Two prospective cohorts were then tested: a group similar to the initial cohort and an HIV1+ cohort. Measurements and Main Results: Healthy smokers had mildly increased levels of EMPs. Strikingly, 95% of smokers with normal spirometry, low Dlco had increased EMPs, with reduced CD62+/CD31+ ratios (P < 10−4) and elevated CD42b−CD31+ annexin V+ EMPs (P < 10−4), suggesting derivation from endothelial apoptosis. Most elevated EMPs were angiotensin-converting enzyme positive, suggesting derivation from pulmonary capillaries. Both prospective cohorts confirmed the initial cohort data. Conclusions: Plasma EMPs with apoptotic characteristics are elevated in smokers with normal spirometry but reduced Dlco, consistent with the concept that emphysema is associated, in part, with capillary endothelium apoptosis, suggesting that the early development of emphysema might be monitored with plasma EMP levels.
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“It is well known that normal spirometry in cigarette smokers may obscure heterogeneous disease of the peripheral airways, lung parenchyma and its vasculature [9,10].”
From Mechanisms of exertional dyspnoea in symptomatic smokers without COPD (2016) · cites this paper as [10]
In the citing paper
“Extensive small airway inflammation has been described in smokers who do not fit conventional diagnostic criteria for COPD [10].”
From Mechanisms of exertional dyspnoea in symptomatic smokers without COPD (2016) · cites this paper as [10]
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Vestbo, J., Hurd, S. S., Agustí, A. G., Jones, P. W., Vogelmeier, C., Anzueto, A., Barnes, P. J., Fabbri, L. M., Martinez, F. J., Nishimura, M., et al. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201204-0596pp · Cited by 15,983
Miller, M. R., Hankinson, J., Brusasco, V., Burgos, F., Casaburi, R., Coates, A., Crapo, R., Enright, P., van der Grinten, C. P. M., Gustafsson, P., et al. (2005) · European Respiratory Journal · doi:10.1183/09031936.05.00034805 · Cited by 15,627
Rabe, K. F., Hurd, S., Anzueto, A., Barnes, P. J., Buist, S. A., Calverley, P., Fukuchi, Y., Jenkins, C., Rodriguez-Roisin, R., van Weel, C., et al. (2007) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200703-456so · Cited by 4,925
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Cited by
Mechanisms of exertional dyspnoea in symptomatic smokers without COPD
Elbehairy, A. F., Guenette, J. A., Faisal, A., Ciavaglia, C. E., Webb, K. A., Jensen, D., Ramsook, A. H., Neder, J. A., & O'Donnell, D. E. (2016) · European Respiratory Journal · doi:10.1183/13993003.00077-2016 · Cited by 99
Metadata
- Authors
- Gordon, C., Gudi, K., Krause, A., Sackrowitz, R., Harvey, B.-G., Strulovici-Barel, Y., Mezey, J. G., & Crystal, R. G.
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-07
- Volume
- 184
- Issue
- 2
- Pages
- 224-232
- ISSN
- 1073-449X
- 1535-4970
- Cited by
- 194
- References
- 3
- Language
- en
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