Plasma markers of endothelial dysfunction in chronic obstructive pulmonary disease

We studied some endothelial cell activity plasma markers, nitric oxide (NO), thrombomodulin (TM), selectins (sP-, sE-, sL-selectin: platelet-P, endothelium-E, Ieukocyte-L), and tissue factor pathway inhibitor (TFPI) in 14 patients with chronic obstructive pulmonary disease (COPD), matched with 20 normal controls, to evaluate their endothelial cell dysfunction. Both NO (patients: 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 significantly decreased in COPD (p < 0.001), sP-selectin levels (patients: 79.4218.20 ng/mL, controls: 37.5 +/-2.84 mg/mL) were significantly higher (p < 0.02), whereas sl-selectin levels (patients: 584.9-78.98 ngimL, controls: 1054.02 +/- 61.28 ng/mL) were significantly decreased in patients 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 endothelial cell dysfunction, and coagulation abnormalities are present in patients with COPD. However, because the endothelium seems to produce a defense mechanism, the potential usefulness of an antithrombotic therapy in these patients needs further investigation.