ROLUL DISBIOZEI INTESTINALE ÎN DISFUNCȚIA ENDOTELIALĂ LA PACIENȚII CU ANGINĂ MICROVASCULARĂ
DOI:
https://doi.org/10.52692/1857-0011.2023.1-75.01Cuvinte cheie:
Disbioză, angina microvasculară, lipopolizaharide, zonulinaRezumat
Scop. Evaluarea nivelurilor circulante ale lipopolizaharidei și zonulinei în contiguitate cu markerii disfuncției endoteliale, inflamației și stresului oxidativ la pacienții cu angină microvasculară (AM). Material și metode. Studiul s-a realizat pe un lot de 58 de pacienți cu AM spitalizați în Institutul de Cardiologie. Determinarea nivelurilor circulante ale 20 de biomarkeri s-a realizat în cooperare cu centrul de investigare de laborator din Universitatea Sapienza (Italia). Toți markerii funcționali și biochimici menționați au fost determinați și la 48 de persoane aparent sănătoase (lotul control) cu valorile cărora s-au comparat markerii pacienților cu AM. Rezultate. Disfuncția endotelială la pacienții cu AM a excelat prin creșterea grosimii complexului intimă-medie a a.carotide cu 41%, precum și reducerea valorii dilatării arterei brahiale mediate de flux (FMD) cu 31,6%. Prezența disbiozei s-a manifestat prin creșterea cu 80% a conținutului seric al lipopolizaharidelor și prin dublarea zonulinei (1,8±0,3 vs 3,6±0,7 ng/ml). Disfuncția endotelială și disbioza au evoluat pe fundalul activării stresului oxidativ estimat prin intermediul a 6 markeri și majorarea conținutului seric al 6 importanți markeri proinflamatori (hsCRP, IL-6, TNF-α, etc.) Concluzii. 1. La pacienții cu AM s-au constatat niveluri circulante elevate mai mult ca dublu ale LPZ și zonulinei față de valoarea control, fapt ce indică asupra prezenței disbiozei intestinale. 2. LPZ și zonulina se corelează robust cu markerii morfofuncționali și biochimici ai disfuncției endoteliale, precum și cu markerii factorilor patogenetici principali ai acesteia, inflamației și stresului oxidativ.
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