COMPARATIVE CHARACTERISTICS OF LEVELS OF PRO-INFLAMMATORY MEDIATORS AND MATRIX METALLOPROTEINASES IN VARIOUS ETIOLOGICAL FORMS OF CEREBRAL MICROANGIOPATHY
Keywords:
cerebral microangiopathy, cerebral small vessel disease, matrix metalloproteinases, MMP-9, pro-inflammatory cytokines, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), inflammatory vasculitis, cerebral amyloid angiopathy, diabetic microangiopathy, neuroinflammation, extracellular matrix degradation, endothelial dysfunction, differential diagnosis, intracerebral hemorrhagesAbstract
Cerebral microangiopathy (CSVD) represents a heterogeneous group of diseases united by damage to the small vessels of the brain but having fundamentally different mechanisms of development. This work presents a comparative analysis of key mediators of neuroinflammation (IL-1β, TNF-α) and proteolysis (MMP-9) in blood and cerebrospinal fluid (CSF) in the main etiological variants of cerebral microangiopathy: hypertensive, amyloid, diabetic, and inflammatory vasculopathy. The study covered 120 patients and 30 control subjects. The obtained data demonstrate that each etiological form is characterized by a unique mediator profile. In the hypertensive form, TNF-α dominates, reflecting systemic endothelial dysfunction; in amyloid angiopathy, a specific "blood-CSF" gradient was revealed with an extreme increase in MMP-9 in the cerebrospinal fluid, correlating with the risk of hemorrhage; in the diabetic form, a systemic increase in all mediators is observed without a pronounced gradient, while in vasculitis, extremely high values indicate immune inflammation. The established patterns open new opportunities for targeted diagnosis and personalization of therapy for cerebral microangiopathy.
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