title: The role of mononuclear cell tissue factor and inflammatory cytokines in patients with chronic thromboembolic pulmonary hypertension.
abstract: Thrombosis and inflammation are two major factors underlying chronic thromboembolic pulmonary hypertension (CTEPH). Tissue factor (TF), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and monocyte chemoattractant protein 1 (MCP-1) may play critical roles in the process of CTEPH thrombosis and pulmonary vascular remodeling. Ten patients with a confirmed diagnosis of CTEPH, 20 patients with acute pulmonary thromboembolism and 15 patients with other types of pulmonary hypertension were enrolled in this study, along with 20 healthy subjects as the control group. The immunoturbidimetric method was used to determine the plasma content of CRP. The plasma levels of TNF-α, MCP-1, and TF antigen were measured by an enzyme-linked immunosorbent assay, and TF activity was measured by the chromogenic substrate method. Percoll density gradient centrifugation was used to separate peripheral blood mononuclear cells from plasma. The level of monocyte TF mRNA was examined by reverse transcriptase-polymerase chain reaction. The correlations between all indices described above were analyzed. In CTEPH patients, the expression of CRP, TNF-α, and MCP-1 was significantly higher than that in controls (P < 0.05). The levels of TF activity, TF antigen, and TF mRNA in monocyte cells were increased in CTEPH patients when compared with control subjects, but only the TF antigen and TF mRNA levels were significantly different (P < 0.05). In CTEPH patients, levels of CRP, MCP-1, and TNF-α significantly correlated with the level of TF antigen in plasma. TF gene expression was increased in patients with CTEPH, suggesting that blood-borne TF mainly comes from mononuclear cells. TF expression significantly correlated with levels of CRP, TNF-α and MCP-1. These factors may play an important role in the development of CTEPH via the inflammation-coagulation-thrombosis cycle.
authors.affiliation: Intensive Care Unit, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
authors.forename: Minxia
authors.initials: M
authors.lastname: Yang
authors.affiliation: Division of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China. jasonsci7333@163.com.
authors.forename: Chaosheng
authors.initials: C
authors.lastname: Deng
authors.affiliation: Division of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
authors.forename: Dawen
authors.initials: D
authors.lastname: Wu
authors.affiliation: Division of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
authors.forename: Zhanghua
authors.initials: Z
authors.lastname: Zhong
authors.affiliation: Division of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
authors.forename: Xiaoting
authors.initials: X
authors.lastname: Lv
authors.affiliation: Division of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Division of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
authors.forename: Ningfang
authors.initials: N
authors.lastname: Lian
authors.affiliation: Division of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
authors.forename: Kaixiong
authors.initials: K
authors.lastname: Liu
authors.affiliation: Division of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
authors.forename: Qiaoxian
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000097:blood; D002908:Chronic Disease; D016207:Cytokines / Q000276:immunology / Q000502:physiology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood*; D009000:Monocytes / Q000378:metabolism; D011655:Pulmonary Embolism / Q000097:blood*; D012333:RNA, Messenger / Q000032:analysis; D013925:Thromboplastin / Q000032:analysis / Q000235:genetics / Q000502:physiology*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D018932:Chemokine CCL2; D016207:Cytokines; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D013925:Thromboplastin
keywords: C-reactive protein; Chronic thromboembolic pulmonary hypertension; Monocyte chemoattractant protein-1; Tissue factor; Tumor necrosis factor-α