Role of kallistatin in pediatric patients with pulmonary arterial hypertension

Role of kallistatin in pediatric patients with pulmonary arterial hypertension

Kallistatin, a serine proteinase inhibitor, exerts its effect by vascular repair, angiogenesis inhibition, strong vasodilation, inhibition of vascular endothelial growth factor (VEGF), antiinflammation, and anti-apoptosis. We hypothesized as to whether it has a protective role in pulmonary arterial...

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Bibliographic Details
Published in:The Turkish journal of pediatrics Vol. 62; no. 3; pp. 405 - 410
Main Authors: Pamukçu, Özge, Ay, Derya, Üzüm, Kazım, Barlakketi, Didem, Köse, Mehmet, Baykan, Ali, Sunkak, Süleyman, Narin, Nazmi
Format: Journal Article
Language:English
Published: Turkey Hacettepe University Faculty of Medicine 2020
Subjects:
Angiogenesis
Apoptosis
Cardiac catheterization
Child
Cytokines
Electrocardiography
Enzymes
Heart
Humans
Hypertension, Pulmonary - drug therapy
Intubation
Male
Patients
Peptides
Pulmonary Arterial Hypertension
Pulmonary arteries
Pulmonary hypertension
Serpins
Tumor necrosis factor-TNF
Variance analysis
Vascular endothelial growth factor
Vascular Endothelial Growth Factor A
Veins & arteries
United States > US
kallistatin
TNFα
pulmonary hypertension
IL-10
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Summary:Kallistatin, a serine proteinase inhibitor, exerts its effect by vascular repair, angiogenesis inhibition, strong vasodilation, inhibition of vascular endothelial growth factor (VEGF), antiinflammation, and anti-apoptosis. We hypothesized as to whether it has a protective role in pulmonary arterial hypertension (PAH). The study included 5 subgroups (78 patients; 44 male): Eisenmenger syndrome (n=16), PAH with left to right shunt (n=20), idiopathic PAH (n=7), patients with left to right shunt without PAH (n=19), and patients with innocent heart murmur (n=16). Physical examination, chest radiography, electrocardiography, and transthoracic echocardiography (TTE) were performed for each patient. PAH diagnosis was confirmed by catheterization. Serum kallistatin, tumor necrosis factor alpha (TNF-α), Interleukin-10 (IL-10) and N-terminal pro b-type natriuretic peptide (NT-proBNP) levels were studied for each patient. The lowest median kallistatin value was found in Eisenmenger syndrome: 1.19 (0.87-3.30) μg/ml. The highest value belonged to control group with innocent murmur: 2.89 (1.19-5.66) μg/ml. Serum levels of kallistatin were significantly lower in patients with PAH (p < 0.05). TNF-α values were increased and IL-10 values were decreased in pulmonary hypertension. However; no correlation was found between kallistatin levels and cytokines. Kallistatin may have a protective effect in pulmonary arterial hypertension by repairing vascular damage, inhibition of angiogenesis, strong vasodilator effect, inhibiting VEGF, and anti-inflammatory mechanism of action. To our knowledge, our study is the first one that shows the role of kallistatin in pulmonary hypertension. Kallistatin may represent a promising novel therapeutic approach for pulmonary hypertension in the near future.
ISSN:0041-4301
2791-6421
DOI:10.24953/turkjped.2020.03.007