(Stroke. 1999;30:1647-1650.)
© 1999 American Heart Association, Inc.
Original Contributions |
Adhesion Molecules in Cerebrovascular Diseases
Evidence for an Inflammatory Endothelial Activation in Cerebral Large- and Small-Vessel Disease
From the Department of Neurology (K.F., O.M., F.M., M.H.) and Institute for Clinical Chemistry (T.B.), University of Heidelberg, Klinikum Mannheim, Mannheim, Germany.
Correspondence to K. Fassbender, MD, Department of Neurology, Klinikum Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer, 68135 Mannheim, Germany.
Background and Purpose—Adhesion molecules mediate attachment and transendothelial migration of leukocytes as a critical step in pathogenesis of atherosclerosis. Their expression and release were comparatively investigated in patients with large- and small-vessel disease of the central nervous system.
Methods—With immunological methods, serum concentrations of endothelial-derived adhesion molecules (soluble endothelial-leukocyte adhesion molecule [sE-selectin], soluble vascular-leukocyte adhesion molecule-1, and soluble intercellular adhesion molecule-1 [sICAM-1]) were quantified in patients with obstructive disease of extracranial (n=89) and intracranial (n=20) large-vessel disease and patients with subcortical vascular encephalopathy (n=64), a cerebral small-vessel disease. As controls, age- and sex-matched subjects without obstructive cerebrovascular disease (n=67) were studied.
Results—We observed significantly increased serum concentrations of sE-selectin and sICAM-1 in patients with both obstructive disease of the large brain-supplying arteries and subcortical vascular encephalopathy. Interestingly, the highest levels were observed in intracranial macroangiopathy. Furthermore, concentrations of sICAM-1 and sE-selectin were significantly increased in current smokers but not in diabetic or hypertensive patients.
Conclusions—The observation of elevated release of endothelial-derived adhesion molecules in both patients with stenoses of the large brain-supplying arteries and patients with subcortical vascular encephalopathy indicates that inflammatory endothelial activation and adhesion of leukocytes play similarly important roles in cerebral large- and small-vessel disease.
Key Words: angiopathy • cell adhesion molecules • cerebrovascular disorders
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