P201. Non invasive endothelial function evaluation in inflammatory bowel diseases
M. Principi1, M. Mastrolonardo2, A. Bucci3, M. Gesualdo4, V. Neve5, F. Albano5, K. Lofano5, M. Ciccone4, A. Di Leo6
1University of Bari, Emergency and Organ Transplantation, Italy; 2University of Foggia, Dermatology, Italy; 3University of Bari, Gastronerology, Italy; 4University of Bari, Cardiology, Italy; 5University of Bari, Gastroenterology, Italy; 6University of Bari, Bari, Italy
Background: In the last decades an ever-growing body of evidence has suggested the involvement of intestinal microvascular endothelial cells in development and maintenance of Inflammatory bowel diseases (IBD). Changes in structure and function of endothelium, mediated by a multifaceted network of chemokines, cytokines and inflammatory growth factors, are a distinctive feature of active disease. In addition, human intestinal microvessels taken from inflamed mucosa exhibit consistent degrees of endothelial dysfunction, with significant impairment of endothelium-dependent (acetylcholine-induced) vasodilation based on decreased endothelial nitric oxide (NO) synthase (eNOS) activity. Endothelial dysfunction may be comprehensively meant a condition in which the varied homeostatic functions of endothelium are impaired. Endothelial function can be measured through the flow-mediated dilation technique (FMD), a well-established non invasive marker, in which changes in the calibre of the brachial artery induced by an increased vessel wall shear stress are measured ultrasonographically.
The present study was designed to evaluate whether FMD at the brachial artery is impaired in a sample of patients with CD and UC in comparison to healthy control subjects. As a secondary measure, intimamedia thickness at the common carotid artery was also calculated as secondary end-point.
Methods: 49 patients (pts) (25 males and 24 females) affected by CD (26) and UC (23) in moderate-severe activity phase with average age of 41 yrs ± 16 were included. Endotelial function was assessed by FMD and shear stress reactive hyperemia; moreover intimamedia thickness of the common carotid artery were measured.
The statistical analyses were made by using Statistica 6.1 software (StatSoft Inc., Tulsa, OK, USA).
Results: Pts with IBD show a FMD % value significatively lower than controls (6.3±3.3 vs 8.1±3.4 p = 0.013); no differences ralated to age, sex, disease duration, comorbility as hypertension or diabetes were found. Likewise intimamedia thickness measurement didn't result different in two groups.
Conclusions: IBD group showed a significant endothelium dysfunction compared with controls and this result was related to systemic inflammation more than to traditional risk factors. Probably the young age of the pts and disease duration, not so long, were the reason for the lack of IMT increase. Further study with IBD group in remission phase will be warranted.