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The Role of Inflammation in the Endothelial Dysfunction in a Cohort of Pediatric

Inflammatory Bowel Disease patients

Andreozzi, Marialuisa*; Giugliano, Francesca Paola*; Strisciuglio, Teresa; Pirozzi, Elisabetta; Papparella, Alfonso; Caprio, Angela Maria; Miele, Erasmo*; Strisciuglio, Caterina; Filardi, Pasquale Perrone

Journal of Pediatric Gastroenterology and Nutrition: May 6, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPG.0000000000002374
Original Article: PDF Only

Objectives: Chronic inflammation plays a central role in the etiology of endothelial damage. Endothelial dysfunction is the inability of the artery to dilate in response to an endothelial stimulus. We assessed the endothelial dysfunction (ED) by measuring the reactive hyperaemia index (RHI) and the flow-mediated dilation (FMD) in a cohort of pediatric patients affected by inflammatory bowel disease (IBD) and comparing these parameters to a group of healthy controls (HC).

Methods: Forty-one patients were consecutive enrolled. ED was evaluated by both the plethysmographic RHI method and the measurement of the FMD of brachial artery after occlusion of the blood flow. Differences between patients and controls were assessed by the Mann-Whitney test. In each IBD patient, the main inflammation markers were detected and correlated to RHI and FMD by a linear regression test.

Results: We enrolled 26 (59%) IBD patients and 18 (41%) HC. When comparing FMD value at diagnosis it was significantly lower in IBD patients than in HC (p = 0.04). This result was confirmed at follow-up, when this difference became even more significant (p = 0.004). A significant indirect correlation was found between FMD and fecal calprotectin (r2:0.17;p = 0.04). No differences were found when comparing RHI.

Conclusions: Our results suggest that inflammation could lead to endothelial dysfunction assessed by ultrasound flow-mediated dilation (FMD). These data were not confirmed by RHI, however this could be due to the lack of a standardized pediatric cut-off. More studies are necessary to confirm our data.

*Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Italy

Department of Woman, Child and General and Specialized Surgery, University of the Campania “Luigi Vanvitelli”, Naples, Italy

Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Italy.

Address correspondence and reprint requests to Caterina Strisciuglio, Department of Woman, Child and General and Specialized Surgery, University of the Campania “Luigi Vanvitelli”, Via Luigi De Crecchio, 2 - 80138 Naples, Italy (E-mail:

Received 13 December, 2018

Accepted 3 April, 2019

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© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,