Assessment of the endothelial glycocalyx state in patients with axial spondyloarthritis associated with Crohn’s disease
- Authors: Davydov D.A.1, Marchenko V.N.1, Kuznetsova D.A.1, Malakhova Z.L.1, Lozovaya T.A.1, Rubinstein A.A.1,2, Vlasov T.D.1
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Affiliations:
- Academician I.P. Pavlov First St. Petersburg State Medical University
- Institute of Experimental Medicine
- Issue: Vol 16, No 1 (2024)
- Pages: 51-62
- Section: Original research
- URL: https://journals.rcsi.science/vszgmu/article/view/256887
- DOI: https://doi.org/10.17816/mechnikov625544
- ID: 256887
Cite item
Abstract
BACKGROUND: Epithelial barrier dysfunction, including their permeability increment, is supposed to be a pathogenetic link in the development of various immunoinflammatory diseases, including Crohn’s disease and axial spondyloarthritits. Endothelial permeability regulation is provided by both intercellular contacts and endothelial glycocalyx.
AIM: To study the microcirculatory state by measuring the endothelial glycocalyx thickness in patients with axial spondyloarthritits associated with Crohn’s disease. To identify an association between the endothelial glycocalyx thinning and the epithelial permeability severity in patients with Crohn’s disease, axial spondyloarthritits and their combination.
MATERIALS AND METHODS: 12 patients with axial spondyloarthritits associated with Crohn’s disease (group A), 22 patients with idiopathic axial spondyloarthritits (group B), 24 patients with Crohn’s disease (group C) and 16 healthy individuals (group D) were examined. The endothelial glycocalyx thickness was assessed in the sublingual region using dark-field microscopy. Fecal calprotectin and fecal zonulin was studied.
RESULTS: A statistically significant increase in the perfused boundary region high flow was found (p = 0.001), as well as the MicroVascular Health Score (p = 0.004) in group A compared with the control. In Group A, a positive correlation between perfused boundary region high flow and scores Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index 10 (p < 0.05) was found; perfused boundary region 5–9 mµ correlated positively with the fecal calprotectin (p = 0.007). Perfused boundary region high flow measurement provides 77.1% accuracy for correct classification of axial spondyloarthritits associated with Crohn’s disease and idiopathic axial spondyloarthritits (p = 0.010). In group C, a positive correlation between fecal zonulin and perfused boundary region 5–9 mµ, 10–19 mµ, 5–25 mµ (p < 0.05) was also found.
CONCLUSIONS: The findings suggest that the patients with axial spondyloarthritits associated with Crohn’s disease have endothelial glycocalyx impairment; the detection of these abnormalities may be useful in assessing the disease integral activity and in the differential diagnosis of axial spondyloarthritits associated with Crohn’s disease and idiopathic axial spondyloarthritits. Further studies of microcirculation will allow better understanding of spondyloarthritis and inflammatory bowel diseases pathogenesis and improve the management of patients with these diseases.
Full Text
##article.viewOnOriginalSite##About the authors
Denis A. Davydov
Academician I.P. Pavlov First St. Petersburg State Medical University
Author for correspondence.
Email: davydov.rheum@gmail.com
ORCID iD: 0000-0002-5524-1616
SPIN-code: 1132-5294
Scopus Author ID: 57217159189
ResearcherId: JWP-2975-2024
MD, postgraduate student
Russian Federation, 6/8 L’va Tolstogo St., Saint Petersburg, 197022Valerii N. Marchenko
Academician I.P. Pavlov First St. Petersburg State Medical University
Email: marchvn@mail.ru
ORCID iD: 0000-0002-2440-7222
SPIN-code: 1711-4150
Scopus Author ID: 57206419660
MD, Dr. Sci. (Med.), Professor
Russian Federation, 6/8 L’va Tolstogo St., Saint Petersburg, 197022Daria A. Kuznetsova
Academician I.P. Pavlov First St. Petersburg State Medical University
Email: lariwar@mail.ru
ORCID iD: 0000-0001-5318-354X
SPIN-code: 6110-6168
Scopus Author ID: 57205585994
MD, Cand. Sci. (Med.)
Russian Federation, 6/8 L’va Tolstogo St., Saint Petersburg, 197022Zinaida L. Malakhova
Academician I.P. Pavlov First St. Petersburg State Medical University
Email: zina_spb@mail.ru
ORCID iD: 0000-0003-2062-290X
SPIN-code: 1225-4143
Scopus Author ID: 56349857400
MD, Department of Ultrasound Diagnostics
Russian Federation, 6/8 L’va Tolstogo St., Saint Petersburg, 197022Tatiana A. Lozovaya
Academician I.P. Pavlov First St. Petersburg State Medical University
Email: lozota@inbox.ru
ORCID iD: 0009-0004-6589-5754
SPIN-code: 2592-8347
Cand. Sci. (Med.), MD, Functional Diagnostics Department №1
Russian Federation, 6/8 L’va Tolstogo St., Saint Petersburg, 197022Artem A. Rubinstein
Academician I.P. Pavlov First St. Petersburg State Medical University; Institute of Experimental Medicine
Email: arrubin6@mail.ru
ORCID iD: 0000-0002-8493-5211
SPIN-code: 6025-1790
Scopus Author ID: 57417440100
ординатор
Russian Federation, 6/8 L’va Tolstogo St., Saint Petersburg, 197022; Saint PetersburgTimur D. Vlasov
Academician I.P. Pavlov First St. Petersburg State Medical University
Email: tvlasov@yandex.ru
ORCID iD: 0000-0002-6951-7599
SPIN-code: 8367-1246
Scopus Author ID: 7003323018
ResearcherId: C-6843-2014
MD, Dr. Sci. (Med.), Professor
Russian Federation, 6/8 L’va Tolstogo St., Saint Petersburg, 197022References
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