Genes hSecurina e VEGF e células endoteliais circulantes como marcadores de angiogênese em portadores de leucemia mielóide crônica / hSecurin and VEGF genes and circulating endothelial cells as markers of angiogenesis in patients with chronic myeloid leukemia

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

03/10/2011

RESUMO

INTRODUCTION: The impact of the increased expression of vascular endothelial growth factor in the course of chronic myeloid leukemia (CML) is still unknown, but there are reports that those patients have higher vascular density in bone marrow than healthy individuals, particularly in blast crisis. Another factor recently associated with increased angiogenesis is the abnormal expression of protein hSecurin, which, in turn, inhibits a protease called separase, responsible for the separation of sister chromatids during the anaphase of mitosis. For these reasons, we quantified circulating endothelial cells and VEGF in patients with CML as a marker of angiogenesis and hSecurin gene expression. METHODS: We performed a prospective analysis of consecutive cases in a cohort of 31 patients with CML in chronic phase at diagnosis, 23 in blast crisis, 30 in accelerated phase who attended the outpatient Hematology FMUSP ward, and 50 healthy subjects, platelet apheresis donors, for quantification of the percentage of circulating endothelial cells and subtypes through the flow cytometry method, at HC/FMUSP Immunopathology laboratory. In this cohort, 25 patients in chronic phase, 14 in blast crisis, 26 in accelerated phase, and 32 healthy subjects were tested for the genes VEGF and hSecurin by quantitative real-time PCR. RESULTS: The median percentage of circulating endothelial cells was 0.0146% in CML in blast crisis and 0.0059% in the control group, p <0.01 at the expense of mature endothelial cells (p <0.01). The median circulating endothelial cells in blast crisis was 0.0146% higher than in accelerated phase (0.0059%), p <0.01 with predominance of mature endothelial cells (p <0.01). Regarding the expression of the VEGF gene, a statistically significant increase was observed in chronic phase (p <0.01), accelerated (p <0.01) and blast crisis (p = 0.04). We found a significant increase in hSecurin gene expression in blast crisis disease, with a median of 0.390 compared to control groups, with a median of 0.125 (p <0.01) and accelerated phase, with a median of 0.230 (p = 0.04). Patients with chronic disease had a median of 0.260 and p = 0.03 compared with the control group. CONCLUSION: In this study, we observed that the quantification of CPB is a useful tool to predict and identify the early progression of CML to blast phase, unlike the VEGF variable, which was elevated in all stages of the disease. The expression of hSecurin gene in chronic phase was significantly higher, demonstrating a likely relationship with the increased cell proliferation rate. However, further studies of hSecurin gene should be made in the blastic crisis of CML to understand precisely the real meaning at this stage of the disease.

ASSUNTO(S)

células endoteliais chronic myeloid leukemia endothelial cells fator de crescimento do endotélio vascular hsecurin hsecurina leucemia mielóide crônica neovascularização fisiológica neovascularization physiologic vascular endothelial growth factor

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