[Blood levels of angiogenic factors in patients with chronic lower limb ischemia at treatment stages].

OBJECTIVE

Comparative analysis of the content of angiogenesis regulatory proteins in patients presenting with chronic lower limb ischemia (CLLI) and undergoing either surgical treatment or conservative therapy supplemented with local administration of autologous platelet lysate.

PATIENTS AND

METHODS

The study included a total of 26 patients with CLLI. Of these, 10 patients (Group 1) were subjected to surgical treatment and 16 (Group 2) underwent conservative therapy alone supplemented with local administration of autologous platelet lysate. The Luminex platform was used to determine the concentration of angiogenic factors EGF, Ang-1, TIE2, VEGF-A, VEGF-R2 in blood of all patients before and 24 hours after surgery (Group 1) or local administration of autologous platelets (Group 2). We also examined the aliquots of the used autologous platelet lysate and blood plasma of 8 apparently healthy volunteer donors. The obtained data were processed using methods of variation statistics.

RESULTS

In chronic ischemia of lower extremities, the concentration of VEGF-A, TIE-2 and VEGF-R2 in blood plasma increased. Group 1 patients demonstrated higher concentrations of Ang-1 and VEGF- A. After surgical restoration of blood flow in the lower extremities, the concentration of cytokines studied did not significantly change. The concentration of EGF, Ang-1 and VEGF-A factors in platelet lysates was significantly higher than in the patients' blood plasma. After local administration of autologous platelets, the concentrations of these factors in the blood plasma of Group 2 patients did not change compared with the baseline values, but there was a significant decrease in the levels of TIE-2 and VEGF-R2.

CONCLUSION

Ischemic tissue damage in CLLI is accompanied by an increase in plasma concentrations of angiogenic factors VEGF-A, VEGF-R2 and TIE-2. Administration of autologous platelet lysate into the ischemic zone does not lead to an increase in the levels of VEGF-A, angiopoietin 1 and EGF in the systemic bloodstream. One of the factors contributing to improved microcirculation in patients with CLLI may be a decrease in plasma levels of VEGF-R2 and TIE-2 after administration of autologous platelet lysate into the ischemic zone. The obtained results suggest further research in this field, with the wide clinical application requiring larger cohorts.