Dağıstan SAKÇİ, Mustafa Burak SAYHAN, Ömer SALT, İlker DİBİRDİK

A Novel Diagnostic Marker in Pulmonary Thromboembolism? Platelet-Derived Growth Factor –β

Objective: Pulmonary thromboembolism (PTE) is a condition characterized by severe cardiopulmonary injury. There is a need for a cheap and reliable biochemical marker, which is also easily and rapidly accessible, with high specificity and sensitivity in the diagnosis of PTE. The PDGF ligand receptor system plays a role in the development of pulmonary hypertension and contributes to thickening of the vascular wall and increasing the wall tension. In the present study, we aimed to investigate whether plasma PDGF-B levels increase in patients with PTE and the diagnostic value of PDGF-B in PTE along with its relationship with mortality. Methods: This prospective clinical study was conducted in the emergency department of a tertiary university hospital between March 1st, 2020 and March 1st, 2021. A total of 44 patients diagnosed as having PTE in the emergency department (patient group) and 34 healthy volunteers without any chronic disease (control group) were included in our study. Results: The PDGF-β levels of the patients diagnosed as having PTE in the ED were found to be significantly higher than those of patients in the control group (Z=-2.015, p=0.044). There was no significant linear relationship between PDGF-β levels and age, gender, presence of chronic disease, systolic and diastolic blood pressure as well as peak heart rate, respiratory rate, and axillary body temperature values at the time of admission to the emergency department, Geneva, Wells and PESI scores. In our study, no significant linear relationship was found between PDGF-β and D-Dimer levels in patients with PTE and mortality. Conclusion: The results obtained from this study, which investigated whether PDGF-B was a new prognostic biomarker for PTE, suggest that plasma PDGF-B levels are significantly higher in PTE cases and can aid in the diagnosis of PTE. However, PDGF-B cannot be used as a marker to predict prognosis

Anahtar Kelimeler:

Biomarker, mortality, PDGF-B, pulmonary thromboembolism, Biomarker, mortality, PDGF-B, pulmonary thromboembolism

A Novel Diagnostic Marker in Pulmonary Thromboembolism? Platelet-Derived Growth Factor –β

Keywords:

Biomarker, mortality, PDGF-B, pulmonary thromboembolism, Biomarker, mortality, PDGF-B, pulmonary thromboembolism,

PDF

___

1. Bruzelius M, Iglesias MJ, Hong MG, et al. PDGFB, a new candidate plasma biomarker for venous thromboembolism: Results from the VEREMA affinity proteomics study. Blood. 2016; 128: e59-66.
2. Alhabibi AM, Eldewi DM, Wahab MAA, et al. Platelet-derived growth factor-beta as a new marker of deep venous thrombosis. J Res Med Sci. 2019; 24: 48.
3. Spronk HM, Cannegieter S, Morange P, et al. Theme 2: epidemiology, biomarkers, and imaging of venous thromboembolism (and postthrombotic syndrome). Thromb Res. 2015; 136 (Suppl 1): 8-12.
4. Yurdakul S, Aytekin S. Diagnostic algorithms in pulmonary hypertension. Anadolu Kardiyol Derg. 2010; 10 (Suppl 1): 14-26.
5. Sinan ÜY, Canbolat İP, Kaya A, et al. Pulmoner Arteriyal Hipertansiyon Hastalarında Serum D vitamini Düzeyleri. Dicle Med J. 2020; 47: 216-22.
6. Öztürk Ö, Akkaya A. Pulmonary arterial hypertension: pathogenesis. Journal of Süleyman Demirel University Faculty of Medicine. 2008; 15: 46-53.
7. Badesch DB, Champion HC, Gomez-Sanchez MA, et al. Diagnosis and assessment of pulmonary arterial hypertension. J Am Coll Cardiol. 2009; 54: 55-66.
8. Cohen AT, Agnelli G, Anderson FA, et al. Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost. 2007; 98: 756-64.
9. Lee CH, Cheng CL, Lin LJ, et al. Epidemiology and predictors of short-term mortality in symptomatic venous thromboembolism. Circ J. 2011;7 5: 1998- 2004.
10. Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost. 2007; 98: 756–64.
11. Keller K, Geyer M, Beule J, et al. Impact of cancer on the effectiveness of cardiac Troponin I to predict right ventricular dysfunction in acute pulmonary embolism. Thorac Cancer. 2015; 6: 584-8.
12. Youssf ARI, Ismail MFM, ElGhamry R, et al. Diagnostic accuracy of D-dimer assay in suspected pulmonary embolism patients. Egypt J Chest Dis Tuberc. 2014; 63: 411-7.
13. Pulivarthi S, Gurram MK. Effectiveness of d dimer as a screening test for venous thromboembolism: An update. N Am J Med Sci. 2014; 6: 491-9.
14. Douma RA, le Gal GG, Söhne M, et al. Potential of an age adjusted D-dimer cut-off value to improve the exclusion of pulmonary embolism in older patients: a retrospective analysis of three large cohorts. BMJ. 2010; 340: c1475.
15. Jensen SB, Hindberg K, Solomon T, et al. Discovery of novel plasma biomarkers for future incident venous thromboembolism by untargeted synchronous precursor selection mass spectrometry proteomics. J Thromb Haemost. 2018; 16: 1763-74.
16. Jeebun V, Doe SJ, Singh L, et al. Are clinical parameters and biomarkers predictive of severity of acute pulmonary emboli on CTPA? Q J Med. 2010; 103: 91-7.
17. Shim AH, Liu H, Focia PJ, et al. Structures of a platelet-derived growth factor/propeptide complex and a platelet-derived growth factor/receptor complex. Proc Natl Acad Sci. 2010; 107: 11307-12.
18. Tannenberg P, Chang YT, Muhl L, et al. Extracellular retention of PDGF-B directs vascular remodeling in mouse hypoxia-induced pulmonary hypertension. Am J Physiol Lung Cell Mol Physiol. 2018; 314: 593-605.
19. Andrae J, Gallini R, Betsholtz C. Role of platelet derived growth factors in physiology and medicine. Genes Dev. 2008; 22: 1276-312.
20. Işık M, Tanyeli Ö, Dereli Y, ve ark. Akut ve Kronik Pulmoner Tromboembolide Cerrahi Tecrübelerimiz. Dicle Med J. 2019; 46: 697-705.
21. Humbert M, Morrell NW, Archer SL, et al. Cellular and molecular pathobiology of pulmonary arterial hypertension. J Am Coll Cardiol. 2004; 43(12 Suppl S): 13S-24.
22. Schwartz SM, Ross R. Cellular proliferation in atherosclerosis and hypertension. Prog Cardiovasc Dis. 1984; 26: 355-72.
23. Das M, Dempsey EC, Bouchey D, et al. Chronic hypoxia induces aggregated growth responses in pulmonary arterial adventitial fibroblast. Am J Respir Crit Care Med. 2000; 22: 15-25.
24. Righini M, Van Es J, Den Exter PL, et al. Age adjusted D-dimer cutoff levels to rule out pulmonary embolism: the ADJUST-PE study. JAMA. 2014; 311: 1117-24.
25. Lobo JL, Zorrilla V, Aizpuru F, et al. D-dimer levels and 15-day outcome in acute pulmonary embolism. Findings from the RIETE Registry. J Thromb Haemost. 2009; 7: 1795-801.
26. Nordenholz KE, Mitchell AM, Kline JA. Direct comparison of the diagnostic accuracy of fifty protein biological markers of pulmonary embolism for use in the emergency department. Acad Emerg Med. 2008; 15: 795-9.
27. Becattini C, Vedovati MC, Agnelli G. Prognostic value of troponins in acute pulmonary embolism: a meta-analysis. Circulation. 2007; 116: 427-33.