Analysis of Vascular Endothelial Function with Ultrasound in Neurological Diseases

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K21428
• Project/Area Number (Other): 18H06345 (2018)
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund (2019); Single-year Grants (2018)
• Review Section: 0908:Society medicine, nursing, and related fields
• Research Institution: Ehime University
• Principal Investigator: Okada Yoko 愛媛大学, 医学部附属病院, 講師(病院教員) (00435025)
• Project Period (FY): 2018-08-24 – 2023-03-31
• Keywords: 血管内皮機能 / Flow mediated dilation / Breath holding index / 超音波 / 多発性硬化症

Outline of Final Research Achievements

Impairment of cerebrovascular reactivity (CVR) has been reported in patients with multiple sclerosis (MS). Chronic inflammation and endothelial dysfunction are possible mechanisms underlying this hemodynamic impairment. Patients with MS and age-/sex-matched healthy controls were assessed for endothelial function, determined by flow-mediated dilation (FMD), and CVR, measured using the breath-holding index (BHI). FMD was significantly lower in MS subjects than in control subjects; furthermore, BHI was similarly lower in MS than in controls, but insignificant. Remarkably, FMD was significantly lower in secondary progressive MS subjects than in relapse-remitting MS subjects. In addition, FMD was inversely correlated with the disability score as per the expanded disability status scale and modified Rankin scale. In patients with MS, endothelial dysfunction was more noticeable than CVR impairment, correlating with the severity and progression of MS.

Free Research Field

脳神経内科

Academic Significance and Societal Importance of the Research Achievements

私たちは超音波検査を用いて、さまざまな神経疾患における内皮機能障害の頻度や病態との関連を解析してきた。特に、中枢神経の自己免疫性疾患である多発性硬化症(MS)において、血管機能が高率に障害されていること、さらに血管内皮機能とMSの重症度との間に関連があることを世界で初めて見いだした(Senzaki et al, Mult Scler Relat Disord, 2021)。近年、MSの再発抑制に貢献する多数の疾患修飾薬が上市されているが、病態の慢性進行(二次進行型)に対する有効な治療薬はほぼない。したがって、血管内皮機能の改善はMSの慢性進行病態に対する治療戦略となる可能性がある。