Endothelial Extracellular Vesicles as Biomarkers of Endothelial Activation in Children With Newly Diagnosed Hypertension

Josip Juraj Strossmayer University of Osijek80 enrolled

Overview

Childhood hypertension is associated with early endothelial dysfunction and an increased risk of future cardiovascular disease. Endothelial extracellular vesicles (EEVs) have emerged as promising biomarkers of endothelial activation; however, their role in pediatric hypertension remains poorly understood. This observational case-control study aims to compare circulating EEV concentrations between normotensive children and children with newly diagnosed, untreated primary hypertension. The study will also investigate the associations between EEV levels, blood pressure, microvascular endothelial function assessed by laser Doppler flowmetry, and circulating biomarkers of endothelial activation. The findings may improve understanding of endothelial injury in pediatric hypertension and support the development of non-invasive biomarkers for early cardiovascular risk assessment.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Pediatric Hypertension Primary Hypertension Endothelial Dysfunction

Eligibility

Sex: ALLMin age: 6 YearsMax age: 17 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Children and adolescents aged 6-17 years. * Written informed consent from a parent or legal guardian and assent from the participant when appropriate. * Normotensive status or newly diagnosed, previously untreated primary hypertension according to current pediatric hypertension guidelines. * Ability to comply with study procedures. Exclusion Criteria: * Secondary hypertension. * Previous antihypertensive treatment. * Congenital heart disease or other significant cardiovascular disease. * Diabetes mellitus. * Chronic kidney disease. * Autoimmune or chronic inflammatory disease. * Acute infection at the time of enrollment. * Malignancy. * Use of medications known to affect endothelial function. * Inability to comply with study procedures.

Outcomes

Primary Outcomes

Plasma endothelial extracellular vesicle concentration

Concentration of circulating endothelial extracellular vesicles quantified by flow cytometry following size-exclusion chromatography isolation.

Time frame: Baseline

Secondary Outcomes

Post-occlusive reactive hyperemia (PORH)

Microvascular endothelium-dependent vasodilation assessed by laser Doppler flowmetry following 1-minute arterial occlusion.

Time frame: Baseline

Acetylcholine-induced vasodilation (AChID)

Endothelium-dependent microvascular vasodilation assessed by acetylcholine iontophoresis and laser Doppler flowmetry.

Time frame: Baseline

Sodium nitroprusside-induced vasodilation (SNPID)

Endothelium-independent microvascular vasodilation assessed by sodium nitroprusside iontophoresis and laser Doppler flowmetry.

Time frame: Baseline

VCAM-1 concentration

Plasma vascular cell adhesion molecule-1 (VCAM-1) concentration measured as a marker of endothelial activation.

Time frame: Baseline

ICAM-1 concentration

Plasma intercellular adhesion molecule-1 (ICAM-1) concentration measured as a marker of endothelial activation.

Time frame: Baseline

Endocan concentration

Plasma endocan concentration measured as a marker of endothelial dysfunction.

Time frame: Baseline

von Willebrand factor (vWF)

Plasma von Willebrand factor concentration measured as a marker of endothelial injury.

Time frame: Baseline

Matrix metalloproteinase-9 (MMP-9)

Plasma MMP-9 concentration measured as a marker of vascular remodeling and endothelial dysfunction.

Time frame: Baseline

Endothelial Extracellular Vesicles as Biomarkers of Endothelial Activation in Children With Newly Diagnosed Hypertension

Overview

Conditions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts