Plasma markers of endothelial dysfunction in chronic obstructive pulmonarydisease

We studied some endothelial cell activity plasma markers, nitric oxide (NO) , thrombomodulin (TM), selectins (sP-, sE-, sL-selectin: platelet-P, endoth elium-E, Ieukocyte-L), and tissue factor pathway inhibitor (TFPI) in 14 pat ients with chronic obstructive pulmonary disease (COPD), matched with 20 no rmal controls, to evaluate their endothelial cell dysfunction. Both NO (pat ients: 23.42 +/-1.67 mug/mL; controls: 40.0 +/-3.38 mug/mL) and TM levels ( patients: 5.46 +/-1.32 ng/mL; controls: 12.9 +/-0.51 ng/mL) were significan tly decreased in COPD (p < 0.001), sP-selectin levels (patients: 79.42<plus /minus>18.20 ng/mL, controls: 37.5 +/-2.84 mg/mL) were significantly higher (p < 0.02), whereas sl-selectin levels (patients: 584.9<plus/minus>-78.98 ngimL, controls: 1054.02 +/- 61.28 ng/mL) were significantly decreased in p atients with COPD (p < 0.001). In contrast, no differences were seen in sE- selectin. Patients with COPD showed a significantly higher (p < 0.001) TFPI antigen plasma level (mean 112.28 +/-6.45 ng/mL; controls 77.68 +/-0.28 ng /mL) than controls. Our data support the concept of some form of endothelia l cell dysfunction, and coagulation abnormalities are present in patients w ith COPD. However, because the endothelium seems to produce a defense mecha nism, the potential usefulness of an antithrombotic therapy in these patien ts needs further investigation.