title: Circulating tissue kallikrein levels correlate with severity of carotid atherosclerosis.
abstract: BACKGROUND
  Vascular growth factors are upregulated in stroke patients, but it remains unknown if they correlate with carotid atherosclerosis.
  
  
  RESULTS
  A case-control study was conducted to determine: (1) possible association between biomarkers of angiogenesis or inflammation and carotid stenosis; and (2) the impact of revascularization on the same biomarkers. Circulating vascular endothelial growth factor (VEGF), basic fibroblast GF (bFGF), tissue kallikrein (tK), and high-sensitivity C-reactive protein (hs-CRP) were measured in 89 patients with carotid obstruction and 45 age-matched controls. Patients were stratified as <50% carotid stenosis (CAS; n=16); 50% to 69% CAS (n=12); 70% to 99% CAS (n=43); and carotid occlusion (CAO; n=18). No association was found between VEGF, bFGF, or hs-CRP and obstruction grading. TK augmented from 360+/-30 in <50% CAS (P=NS versus controls) to 509+/-72 in moderate CAS (P<0.05), 1159+/-178 in high-grade CAS (P<0.02), and 1616+/-403 pg/mL in CAO (P<0.01). A threshold of 508 pg/mL provided the maximized predictive value of high-grade obstruction. After revascularization, tK decreased from 1410+/-352 to 782+/-86 pg/mL (P<0.01), whereas no change was detected in nonoperated cases. Hs-CRP was unaffected by revascularization.
  
  
  CONCLUSIONS
  Angiogenic factors are heterogeneously expressed in patients with carotid atherosclerosis. The tK measurement may be useful for the diagnosis and monitoring of atherosclerotic disease.
authors.affiliation: Institute of Internal Medicine, Medical University of Sassari, Sassari, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Porcu
authors.forename: Costanza
authors.initials: C
authors.lastname: Emanueli
authors.forename: Elisa
authors.initials: E
authors.lastname: Desortes
authors.forename: Giovanni M
authors.initials: GM
authors.lastname: Marongiu
authors.forename: Franco
authors.initials: F
authors.lastname: Piredda
authors.forename: Lee
authors.initials: L
authors.lastname: Chao
authors.forename: Julie
authors.initials: J
authors.lastname: Chao
authors.forename: Paolo
authors.initials: P
authors.lastname: Madeddu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis; D016893:Carotid Stenosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery; D016022:Case-Control Studies; D016894:Endarterectomy, Carotid; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000097:blood; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D020840:Tissue Kallikreins / Q000097:blood*; D016896:Treatment Outcome; D014463:Ultrasonography; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D015415:Biomarkers; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D016222:Fibroblast Growth Factor 2; D002097:C-Reactive Protein; D020840:Tissue Kallikreins