Peripheral VCAM-1 Level And Wilkins Score In Mitral Stenosis Of Rheumatic Heart Disease

Authors

  • Romi Ermawan Universitas Mataram

DOI:

https://doi.org/10.29303/jku.v10i4.606

Abstract

Abstract

Background: Vascular cell adhesion molecule-1 (VCAM-1) is an important protein in the progression of mitral valve damage in rheumatic heart disease. To measure the severity of the damage, there is a scoring system known as Wilkins Score, consisting of valve mobility disorder, valve thickening, valve calcification and sub-valvular thickening.

Methods: This analytic-observational study was using cross-sectional design. There were 45 patients with mitral stenosis of rheumatic heart disease who were collected by consecutive sampling. The peripheral VCAM-1 level was obtained from peripheral venous access, and echocardiogram was obtained to assess Wilkin Score as well as other related parameters. There were also 22 normal subjects who got involved as comparison.

Results: The mean Wilkins Score of patients are 9,09 ± 1,81. The mean peripheral VCAM-1 level of patients and normal subjects are 1155,3 ± 328,8 ng/mL and 605,5 ± 100,4 ng/mL. There is significant difference in peripheral VCAM-1 level between 2 groups (p<0,001). There are also significant positive correlations between peripheral VCAM-1 level and valve mobility disorder (p<0,001, r = +0,522), valve thickening (p<0,001, r = +0,583), valve calcification (p<0,001, r = +0,538), sub-valvular thickening (p <0,001, r = +0,647), and also Wilkin Score (p<0,001, r = +0,841).

Conclusion: There is a significant positive correlation between peripheral VCAM-1 level and Wilkins Score in mitral stenosis of rheumatic heart disease.

 

Keyword: VCAM-1 - Wilkins Score - Mitral Stenosis - Rheumatic Heart Disease

References

1. Marijon E, Mirabel M, Celermajer DS, Jouven X. Rheumatic heart disease. Lancet. 2012;379:953–64.
2. Rheumatic fever and rheumatic heart disease: report of a WHO expert consultation. Geneva: World Health Organization; 2001. 13–18 p. (923).
3. Guilherme L, Kalil J, Cunningham MW. Molecular mimicry in the autoimmune pathogenesis of rheumatic heart disease. Autoimmunity. 2006;39(1):31–9.
4. Guilherme L, Kalil J. Rheumatic fever and rheumatic heart disease: cellular mechanisms leading autoimmune reactivity and disease. J Clin Immunol. 2010;30:17–23.
5. Carapetis JR. Rheumatic heart disease in Asia. Circulation. 2008;118:2748–53.
6. Bonow RO, Carabello BA, Chatterjee K, Leon AC de, Faxon DP, Freed MD, et al. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (writing committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Circulation. 2008;118(15):e523–661.
7. Baumgartner H, Hung J, Bermejo J, Chambers JB, Evangelista A, Griffin BP, et al. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. Journal of the American Society of Echocardiography. 2009;22(1):1–23.
8. Singh RJR, Mason JC, Lidington EA, Edwards DR, Nuttall RK, Khokha R, et al. Cytokine stimulated vascular cell adhesion molecule-1 (VCAM-1) ectodomain release is regulated by TIMP-3. Cardiovasc Res. 2005;67(1):39–49.
9. Ulyanova T, Scott LM, Priestley GV, Jiang Y, Nakamoto B, Koni PA, et al. VCAM-1 expression in adult hematopoietic and nonhematopoietic cells is controlled by tissue-inductive signals and reflects their developmental origin. Blood. 2005;106(1):86–94.
10. Cybulsky MI, Iiyama K, Li H, Zhu S, Chen M, Iiyama M, et al. A major role for VCAM-1, but not ICAM-1, in early atherosclerosis. J Clin Invest. 2001;107(10):1255–62.
11. Fotis L, Giannakopoulos D, Stamogiannou L, Greece A. Intercellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 in children. Do they play a role in the progression of atherosclerosis? Hormones. 2012;11(2):140–6.
12. Braun M, Pietsch P, Schrör K, Baumann G, Felix SB. Cellular adhesion molecules on vascular smooth muscle cells. Cardiovasc Res. 1999;41(2):395–401.
13. Yusuf-Makagiansar H, Anderson ME, Yakovleva TV, Murray JS, Siahaan TJ. Inhibition of LFA-1/ICAM-1 and VLA-4/VCAM-1 as a therapeutic approach to inflammation and autoimmune diseases. Medicinal Research Reviews. 2002;22(2):146–67.
14. Ulbrich H, Eriksson EE, Lindbom L. Leukocyte and endothelial cell adhesion molecules as targets for therapeutic interventions in inflammatory disease. Trends in Pharmacological Sciences. 2003;24(12):640–7.
15. Foster CA. VCAM-1/?4-integrin adhesion pathway: Therapeutic target for allergic inflammatory disorders. Journal of Allergy and Clinical Immunology. 1996;98(6, Part 2):S270–7.
16. McMurray RW. Adhesion molecules in autoimmune disease. Seminars in Arthritis and Rheumatism. 1996;25(4):215–33.
17. Cunningham MW. Autoimunity and molecular mimicry in the pathogenesis of post-streptococal heart disease. Frontiers in Bioscience. 2003;8:s533–43.
18. Nilsson J. Cytokine and smooth muscle cells in atherosclerosis. Cardiovasc Res. 1993;27:1184–90.
19. Artola RT, Mihos CG, Santana O. The immunology of mitral valve stenosis. International Journal of Interferon, Cytokine and Mediator Research. 2011;3:1–8.
20. Guilherme L, Faé K, Oshiro SE, Kalil J. Molecular pathogenesis of rheumatic fever and rheumatic heart disease. Expert Reviews in Molecular Medicine. 2005;7(28):1–14.
21. Tandon R. Rheumatic fever pathogenesis: approach in research needs change. Annals of Pediatric Cardiology. 2012;5(2):169–78.
22. van der Bel-kahn J, Becker AE. The surgical pathology of rheumatic and floppy mitral valves. Distinctive morphologic features upon gross examination. Am J Surg Pathol. 1986;10(4):282–92.
23. Olson LJ, Subramanian R, Ackermann DM. Surgical pathology of the mitral valve: a study of 712 cases spanning 21 years. Mayo Clin Proc. 1987;62(1):22–34.
24. Schoen FJ, Padera RFJ. Cardiac surgical pathology. In: Cohn LH, Edmunds LHJ, editors. Cardiac surgery in the adult. New York: McGraw-Hill Companies; 2003. p. 119–85.
25. Rashed M, Nagm M, Ragab N. Clinical and histopathologic study of surgically excised mitral valves in children. The Internet Journal of Pathology. 2006;5(2).
26. Rajamannan NM, Nealis TB, Subramaniam M. Calcified rheumatic valve neoangiogenesis is associated with vascular endothelial growth factor expression and osteoblast-like bone formation. Circulation. 2005;111:3296–301.
27. Mazzone A, Epistolato MC, De Caterina R, Storti S. Neoangiogenesis, T-lymphocyte infiltration, and heat shock protein-60 are biological hallmarks of an immunomediated inflammatory process in end-stage calcified aortic valve stenosis. J Am Coll Cardiol. 2004;43(9):1670–6.
28. Wilkins GT, Weyman AE, Abascal VM, Block PC, Palacios IF. Percutaneous balloon dilatation of the mitral valve: an analysis of echocardiographic variables related to outcome and the mechanism of dilatation. Br Heart J. 1988;60(4):299–308.
29. Alatas H, Karyomanggolo WT, Musa DA, Boediarso A, Oesman IN, Idris NS. Desain penelitian. In: Sastroasmoro S, Ismael S, editors. Dasar-dasar metodologi penelitian klinis. 4th ed. Jakarta: Sagung Seto; 2011. p. 104–27.
30. Sastroasmoro S. Pemilihan subyek penelitian. In: Sastroasmoro S, Ismael S, editors. Dasar-dasar metodologi penelitian klinis. 4th ed. Jakarta: Sagung Seto; 2011. p. 88–101.
31. Ellis NMJ, Li Y, Hildebrand W, Fischetti VA, Cunningham MW. T cell mimicry and epitope specificity of cross-reactive T cell clones from rheumatic heart disease. The Journal of Immunology. 2005;175:5448–56.
32. Guilherme L, Cury P, Demarchi LMF, Coelho V, Abel L, Lopez AP, et al. Rheumatic heart disease: proinflammatory cytokines play a role in the progression and maintenance of valvular lesions. Am J Pathol. 2004;165(5):1583–91.
33. Sampaio RO, Fae´ KC, Demarchi LMF, Pomerantzeff PMA, Aiello VD, Spina GS, et al. Rheumatic heart disease: 15 years of clinical and immunological follow-up. Vascular Health and Risk Management. 2007;3(6):1007–17.
34. Roberts S, Kosanke S, Terrence Dunn S, Jankelow D, Duran CM, Cunningham MW. Pathogenic mechanisms in rheumatic carditis: focus on valvular endothelium. J Infect Dis. 2001;183(3):507–11.
35. Yetkin E, Erbay AR, ?eri M, Turhan H, Balci M, Çehreli S, et al. Levels of circulating adhesion molecules in rheumatic mitral stenosis. American Journal of Cardiology. 2001;88(10):1209–11.
36. Chen L-P, Liu H, Huang Y, Zhang X-Y, Alexander RE, Cheng L. Expression of NFkappaB, ICAM1, and VCAM1 in rheumatic heart disease with atrial fibrillation. Anal Quant Cytol Histol. 2013;35(5):249–52.

Downloads

Published

2022-01-22

How to Cite

Romi Ermawan. (2022). Peripheral VCAM-1 Level And Wilkins Score In Mitral Stenosis Of Rheumatic Heart Disease. Jurnal Kedokteran, 10(4), 629–638. https://doi.org/10.29303/jku.v10i4.606

Issue

Section

Research

Most read articles by the same author(s)