Relationship between fibroblast growth factor in plasma and carotid plaque neovascularization: a pilot study

Front Immunol. 2024 Apr 22:15:1385377. doi: 10.3389/fimmu.2024.1385377. eCollection 2024.

Abstract

Background: Unstable atherosclerotic carotid plaques with intraplaque neovascularization (IPN) carry a substantial risk for ischemic stroke. Conventional ultrasound methods fall short in detecting IPN, where superb microvascular imaging (SMI) has emerged as a promising tool for both visualizing and quantification. High levels of fibroblast growth factor 23 (FGF-23) have, in observational studies, been suggested as related to cardiovascular morbidity and mortality. The association of FGF-23 to atherosclerotic carotid plaque instability remains relatively unexplored.

Methods: A cohort of twenty-nine patients with ≥50% atherosclerotic carotid stenosis underwent conventional carotid ultrasound, SMI, and blood tests, including measurement of FGF-23 in plasma. Nineteen patients were characterized as symptomatic and ten as asymptomatic.

Results: Our major findings were: i) Higher FGF-23 levels were strongly correlated with increased SMI-assessed IPN. ii) Neo-vessel count recorded by quantitative SMI was positively correlated to increased FGF-23 levels, but not with basic FGF levels. (iii) In contrast, traditional risk factors for plaque instability exhibited no noteworthy associations with SMI-assessed IPN or with FGF-23 levels.

Conclusion: This pilot study suggest the potential of FGF-23 as a valuable marker for neovascularization and atherosclerotic carotid plaque instability as a risk factor for ischemic stroke. Further research involving larger cohorts and prospective data is necessary to understand FGF-23's role in this context comprehensively.

Keywords: atherosclerosis; fibroblast growth factor-23; intraplaque hemmorhage; intraplaque neovascularization (IPN); ischemic stroke; superb microvascular imaging (SMI); unstable carotid artery plaque.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers* / blood
  • Carotid Stenosis* / blood
  • Carotid Stenosis* / diagnostic imaging
  • Female
  • Fibroblast Growth Factor-23* / blood
  • Humans
  • Male
  • Middle Aged
  • Neovascularization, Pathologic* / blood
  • Pilot Projects
  • Plaque, Atherosclerotic* / blood
  • Plaque, Atherosclerotic* / diagnostic imaging

Substances

  • Biomarkers
  • FGF23 protein, human
  • Fibroblast Growth Factor-23

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study is funded by South-Eastern Norway Regional Health Authority (ID 2010011).