The investigation of the relationship between plasma viscosity and endothelial dysfunction markers in patients with essential thrombocytosis and reactive thrombocytosis

Essential thrombocytosis (ET) is a rare stem cell disease causing increased platelet numbers with impaired function. Endothelium that is induced biomechanically by plasma viscosity-one of the determinants of blood flow-alterations secretes endothelial dysfunction markers behaving like a receptor. The aim of our study is to investigate the relationship between plasma viscosity and plasma nitric oxide (NO), asymmetric dimethylarginine (ADMA), vascular cell adhesion molecule-1 (VCAM-1) and intracellular adhesion molecule-1 (ICAM-1) as endothelial dysfunction markers in ET. The study groups were randomly classified as patients diagnosed with ET (ET-Group), patients with reactive thrombocytosis related with iron deficiency anemia (IDA-RT-Group) and healthy controls (HC-Group). Plasma viscosity and plasma levels of endothelial dysfunction markers were measured utilizing Harkness capillary viscosimeter and ELISA method, respectively. Plazma NO level was evaluated with plasma nitric oxide synthase (NOS) level. ANOVA, Kruskal-Wallis tests and Pearson correlation test were used for statistical analysis. Plasma viscosity and plasma VCAM-1 were significantly higher in ET and IDA-RT Groups than HC-Group. Plasma ADMA was statistically higher in HC-Group compared with other groups. HC-Group had higher ICAM-1 compared with ET-Group. No significancy in plasma NOS among study groups and decseased ADMA in thrombocytosis groups might indicate that endothelial dysfunction can't be detected quantitatively by means of NOS and ADMA. Plasma viscosity, fibrinogen and VCAM-1 increased concurrently in thrombocytosis groups that might be an indicator of endothelial inflammation. In conclusion, it can be estimated that endothelial dysfunction has started and endothelium has been transforming into a pro-thrombotic and pro-atherogenic surface. We hypothesize that plasma viscosity measurement can be used routinely as a gold standard with its simplicity, cheapness, repeatability and rapidness in diagnosis, treatment, follow-up and preventing cardiovascular complications of ET patients for determination of blood flow alterations and endothelial dysfunction.