Neutrophil elastase, von Willebrand factor, soluble thrombomodulin and percutaneous oxygen in peripheral atherosclerosis

Objectives: To test the hypothesis that endothelial cell damage and hypoxia are related to the activity of neutrophil elastase in patients with peripheral atherosclerosis. Design: A cross-sectional serological study in a tertiary referral, University Hospital. Materials: Venous blood was obtained from 22 patients with peripheral vascular disease and an equal number of age and se?: matched controls. Methods: Neutrophil elastase and two markers of endothelial cell damage (von Willebmnd factor and soluble thrombomodulin) were measured in plasma by ELISA. Hypoxia was measured by percutaneous oxygen (by oximeter) at the dorsum of the foot. Results: Patients had higher volt Willebrand factor, higher soluble thrombomodulin and higher elastase but lower percutaneous oxygen (all p<0.001). In the patient's group, there were significant inverse correlates between von Willebrand factor and percutaneous oxygen (p = 0.004) and between soluble thrombomodulin and percutaneous oxygen (p = 0.011) while elastase correlated positively with soluble thrombomodulin (p = 0.023). Conclusions: Our data support the hypothesis that release of elastase from activated neutrophils relates to endothelial cell damage. This may contribute to hypoxia and may result in the deterioration in clinically assessed atherosclerosis.