■系统性硬化症(SSc)患者内皮功能障碍的风险增加,动脉粥样硬化,和心血管事件与普通人群相比。因此,内皮功能障碍和动脉粥样硬化形成的可靠循环生物标志物的可用性可能有助于SSc患者心血管风险的早期识别和管理.我们试图通过对研究涉及内皮功能障碍和动脉粥样硬化的各种类型的循环细胞粘附分子的研究进行系统综述和荟萃分析来解决这一问题(即,免疫球蛋白样血管细胞,VCAM-1,细胞间,ICAM-1,血小板内皮细胞,PECAM-1神经细胞,NCAM,唐氏综合症细胞,DSCAM,和内皮细胞选择性,ESAM,粘附分子,E-,L-,和P-选择素,整合素,和钙黏着蛋白)在SSc患者和健康对照中。
■我们搜索了PubMed,Scopus,和WebofScience从成立到2024年5月1日。使用经过验证的工具评估偏倚和证据确定性的风险。
■在43项符合条件的研究中,与对照组相比,SSc患者的血浆或血清ICAM-1浓度显着升高(标准平均差,SMD=1.16,95%CI0.88至1.44,p<0.001;中等确定性),VCAM-1(SMD=1.09,95%CI0.72至1.46,p<0.001;中等确定性),PECAM-1(SMD=1.65,95%CI0.33至2.98,p=0.014;确定性非常低),E-选择素(SMD=1.17,95%CI0.72至1.62,p<0.001;中等确定性),和P-选择素(SMD=1.10,95%CI0.31至1.90,p=0.007;低确定性)。L-选择素浓度在组间没有显著差异(SMD=-0.35,95%CI-1.03至0.32,p=0.31;确定性非常低),而钙黏着蛋白的证据很少/没有,NCAM,DSCAM,ESAM,或整合素。总的来说,在荟萃回归和亚组分析中,效应大小与不同患者和研究特征之间未观察到显著关联.
■本系统综述和荟萃分析的结果表明,特定的循环细胞粘附分子,即,ICAM-1,VCAM-1,PECAM-1,E-选择素,和P-选择素,作为内皮功能障碍和动脉粥样硬化形成的生物标志物,可用于评估SSc患者的心血管风险。
■https://www.crd.约克。AC.英国/普华永道/,标识符CRD42024549710。
UNASSIGNED: Patients with systemic sclerosis (SSc) have an increased risk of endothelial dysfunction, atherosclerosis, and cardiovascular events compared to the general population. Therefore, the availability of robust circulating biomarkers of endothelial dysfunction and atherogenesis may facilitate early recognition and management of cardiovascular risk in SSc. We sought to address this issue by conducting a systematic
review and meta-analysis of studies investigating various types of circulating cell adhesion molecules involved in endothelial dysfunction and atherogenesis (i.e., immunoglobulin-like vascular cell, VCAM-1, intercellular, ICAM-1, platelet endothelial cell, PECAM-1, neural cell, NCAM, Down syndrome cell, DSCAM, and endothelial cell-selective, ESAM, adhesion molecules, E-, L-, and P-selectin, integrins, and cadherins) in SSc patients and healthy controls.
UNASSIGNED: We searched PubMed, Scopus, and Web of Science from inception to 1 May 2024. Risk of bias and certainty of evidence were assessed using validated tools.
UNASSIGNED: In 43 eligible studies, compared to controls, patients with SSc had significantly higher plasma or serum concentrations of ICAM-1 (standard mean difference, SMD=1.16, 95% CI 0.88 to 1.44, p<0.001; moderate certainty), VCAM-1 (SMD=1.09, 95% CI 0.72 to 1.46, p<0.001; moderate certainty), PECAM-1 (SMD=1.65, 95% CI 0.33 to 2.98, p=0.014; very low certainty), E-selectin (SMD=1.17, 95% CI 0.72 to 1.62, p<0.001; moderate certainty), and P-selectin (SMD=1.10, 95% CI 0.31 to 1.90, p=0.007; low certainty). There were no significant between-group differences in L-selectin concentrations (SMD=-0.35, 95% CI -1.03 to 0.32, p=0.31; very low certainty), whereas minimal/no evidence was available for cadherins, NCAM, DSCAM, ESAM, or integrins. Overall, no significant associations were observed between the effect size and various patient and study characteristics in meta-regression and subgroup analyses.
UNASSIGNED: The results of this systematic
review and meta-analysis suggest that specific circulating cell adhesion molecules, i.e., ICAM-1, VCAM-1, PECAM-1, E-selectin, and P-selectin, can be helpful as biomarkers of endothelial dysfunction and atherogenesis in the assessment of cardiovascular risk in SSc patients.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/, identifier CRD42024549710.