Introduction: Endothelial dysfunction (ED) plays a significant role in
the development of cerebral small vessel disease (SVD). Analyzing
biomarkers related to endothelial function, obtainable from peripheral
blood, offers valuable insights for researchers. However, the link
between biomarkers of ED and cerebral SVD remains controversial.
Our primary aim was to investigate the relationship between the
biomarkers of ED by analyzing intercellular adhesion molecule-1
(ICAM-1), plasminogen activator inhibitor-1 (PAI-1), asymmetric
dimethylarginine (ADMA), interleukin-6 (IL-6), C-reactive protein
(CRP), and specific clinical findings of cerebral small vessel disease
(SVD), such as the presence of minor stroke or cognitive impairment.
We also performed a correlation analysis between ED biomarkers and
neuroimaging markers of cerebral SVD.
Methods: Patients with cerebral SVD were grouped according to
their symptoms. We compared the serum biomarkers of ED between
patient groups. All biomarkers except CRP were studied using enzyme-
linked immunosorbent assay. We also performed a correlation analysis
between cerebral SVD biomarkers in neuroimaging and ED biomarkers.
Results: We included 68 patients in this study. Patients with minor
stroke or cognitive deficits had lower levels of PAI-1 than asymptomatic
patients, and this finding was more evident in patients with cognitive
deficits. Enlarged perivascular spaces (EPVSs) in the basal ganglia score
positively but slightly correlated with serum ADMA levels.
Conclusion: PAI-1 has a possible neuroprotective effect against the
development of cognitive impairment in cerebral SVD. Biomarkers of
ED differ according to the severity, and localization of the lesions. There
was a specific relationship between ADMA and EPVSs in basal ganglia,
-not EPVSs in the centrum semiovale- irrespective of vascular risk factors
suggesting EPVSs in the centrum semiovale and basal ganglia may be the
product of different pathological processes.
Keywords: ADMA; cerebral small vessel disease; CRP; endothelial