eISSN: 1644-4124
ISSN: 1426-3912
Central European Journal of Immunology
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3/2019
vol. 44
 
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abstract:
Clinical immunology

Markers of endothelial injury and subclinical inflammation in children and adolescents with primary hypertension

Piotr Skrzypczyk
1
,
Anna Ozimek
1
,
Anna Ofiara
2
,
Michał Szyszka
2
,
Jarosław Sołtyski
1
,
Anna Stelmaszczyk-Emmel
3
,
Elżbieta Górska
3
,
Małgorzata Pańczyk-Tomaszewska
1

1.
Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland
2.
Student Scientific Group at the Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland
3.
Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Warsaw, Poland
(Centr Eur J Immunol 2019; 44 (3): 253-261)
Online publish date: 2019/09/30
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Introduction
Adhesion molecules: E-selectin and intercellular adhesion molecule 1 (ICAM-1) are well-established markers of endothelial injury. The aim of the study was to assess the relation between E-selectin and ICAM-1 and clinical and biochemical parameters in children and adolescents with primary hypertension (PH).

Material and methods
In 77 patients with PH (15.04 ±2.62 years, 50 boys, 27 girls) we evaluated serum E-selectin, ICAM-1, and selected clinical and biochemical parameters including inflammatory indicators and ambulatory blood pressure monitoring (ABPM).

Results
The E-selectin concentration was 55.63 ±26.49 ng/ml and the ICAM-1 concentration was 302.17 ±67.14 ng/ml. E-selectin and ICAM-1 correlated (p < 0.05) with BMI Z-score (r = 0.24, r = 0.29), ICAM-1 also with uric acid (r = 0.35), HDL-cholesterol (r = –0.28), platelet-to-lymphocyte ratio (r = 0.26), and systolic and mean blood pressure variability (r = 0.24, r = 0.24); in boys ICAM-1 correlated with mean platelet volume (r = 0.29). In multivariate analysis the only significant predictor of E-selectin was mean arterial pressure during 24 hours (β = 0.329, 95% CI: 0.012-0.646) and of ICAM-1 – uric acid (β = 0.430, 95% CI: 0.040-0.819). In 27 children with newly diagnosed PH E-selectin correlated negatively with diastolic blood pressure dipping (r = –0.54, p = 0.004) and positively with ambulatory arterial stiffness index (r = 0.51, p = 0.012).

Conclusions
Elevated mean arterial pressure and hyperuricemia are risk factors of endothelial damage in paediatric patients with primary hypertension. In children with untreated primary hypertension there may be a relation between endothelial damage and disturbed circadian blood pressure profile.

keywords:

children, ICAM-1, adolescents, E-selectin, endothelial injury, primary hypertension, subclinical inflammation

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