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Stroke. 1997;28:2214-2218

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*Carotid Artery Disease

(Stroke. 1997;28:2214-2218.)
© 1997 American Heart Association, Inc.


Articles

Soluble Adhesion Molecules Reflect Endothelial Cell Activation in Ischemic Stroke and in Carotid Atherosclerosis

C.J.M. Frijns, MD; L.J. Kappelle, MD; J. van Gijn, MD, FRCP; H.K. Nieuwenhuis, MD; J.J. Sixma, MD; R. Fijnheer, MD

From the Departments of Neurology (C.J.M.S., L.J.K., J. van G.) and Hematology (H.K.N., J.J.S., R.F.), University Hospital Utrecht (Netherlands).

Correspondence to C.J.M. Frijns, MD, Department of Neurology, University Hospital Utrecht, PO Box 85500, Heidelberglaan 100, 3584 CX Utrecht, Netherlands. E-mail C.Frijns{at}neuro.azu.nl

Background and Purpose Activation of endothelial cells and platelets plays an important role in the development of atherosclerosis and thrombotic disorders. Soluble adhesion molecules originating from these cells can be demonstrated in plasma. We hypothesized that elevated plasma concentrations of soluble P-selectin (sP-selectin), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and soluble E-selectin (sE-selectin) can reflect activation of endothelial cells and/or platelets in acute ischemic stroke and in previously symptomatic internal carotid artery stenosis.

Methods Plasma was sampled from patients within 2 days of acute ischemic stroke (n=28), from patients with a previous (>1 week) transient or persistent ischemic neurological deficit associated with stenosis of the internal carotid artery (n=34), and from control patients without a history of vascular disease (n=34). Concentrations of sP-selectin, sICAM-1, sVCAM-1, and sE-selectin were measured by means of an enzyme-linked immunosorbent assay.

Results Compared with control subjects, sP-selectin and sE-selectin were significantly elevated in the acute stage of ischemic stroke (P<.0001 and P=.001, respectively) as well as in previously symptomatic carotid stenosis (P<.0001 and P=.0007). sICAM-1 and sVCAM-1 were not increased.

Conclusions The elevated levels of sE-selectin indicate that endothelial cell activation occurs both in the acute stage of ischemic stroke and in previously symptomatic carotid atherosclerosis. Increased sP-selectin concentrations reflect endothelial cell activation as well but may also be caused by platelet activation.


Key Words: carotid stenosis • cell adhesion molecules • cerebral infarction • endothelial




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