A longitudinal prospective study of soluble adhesion molecules in acute stroke

被引:96
作者
Bitsch, A
Klene, W
Murtada, L
Prange, H
Rieckmann, P
机构
[1] Univ Gottingen, Dept Neurol, D-3400 Gottingen, Germany
[2] Univ Wurzburg, Dept Neurol, D-8700 Wurzburg, Germany
关键词
cell adhesion molecules; cerebral ischemia; transient; selectins; stroke;
D O I
10.1161/01.STR.29.10.2129
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-Activation of endothelial cells is a consequence of cerebral ischemia and leads to the expression of adhesion molecules such as intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), and E-selectin, which can be released into the blood. This study aimed to define the kinetics of soluble adhesion molecule serum levels after cerebral ischemia and their correlation with the extent of neurological deficits, clinical outcome, and infarct volume as measured on CT scans. Methods-Plasma levels of soluble (s) ICAM-1, sVCAM-1, and sE-selectin were repeatedly determined by ELISA in 38 patients during a period of 14 days after acute cerebral ischemia. Results-Soluble adhesion molecule levels demonstrated considerable variability. Overall, concentrations revealed characteristic and significant changes after completed strokes but not after transient ischemic attacks. In patients with completed stroke (n=26) but not in patients with transient ischemic attacks (n=12), sICAM-1 peaked within 24 hours (P=0.04), sVCAM-1 reached a maximum after 5 days (P=0.02), and sE-selectin levels decreased after 5 days (P=0.002). There was no clear-cut correlation of soluble adhesion molecule levels with infarct volume or clinical disability. The initial increase of sE-selectin levels was higher in more disabled patients (P=0.02). sICAM-1 levels were higher in patients with signs of infection (n=9; P=0.03). Conclusions-As a result of large interindividual variability influenced by ischemia-independent factors, soluble adhesion molecules are not reliable candidates as surrogate markers in acute cerebral ischemia. The characteristic profile of individual soluble adhesion molecules after completed stroke supports prior hypotheses of their involvement in the pathogenesis of acute cerebral ischemia, but this needs to be clarified in detail.
引用
收藏
页码:2129 / 2135
页数:7
相关论文
共 33 条
  • [1] The role of inflammation and cytokines in brain injury
    Arvin, B
    Neville, LF
    Barone, FC
    Feuerstein, GZ
    [J]. NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS, 1996, 20 (03) : 445 - 452
  • [2] MONOCLONAL-ANTIBODY TO THE ICAM-1 ADHESION SITE REDUCES NEUROLOGICAL DAMAGE IN A RABBIT CEREBRAL EMBOLISM STROKE MODEL
    BOWES, MP
    ZIVIN, JA
    ROTHLEIN, R
    [J]. EXPERIMENTAL NEUROLOGY, 1993, 119 (02) : 215 - 219
  • [3] MONOCLONAL-ANTIBODIES PREVENTING LEUKOCYTE ACTIVATION REDUCE EXPERIMENTAL NEUROLOGIC INJURY AND ENHANCE EFFICACY OF THROMBOLYTIC THERAPY
    BOWES, MP
    ROTHLEIN, R
    FAGAN, SC
    ZIVIN, JA
    [J]. NEUROLOGY, 1995, 45 (04) : 815 - 819
  • [4] CARLOS TM, 1994, BLOOD, V84, P2068
  • [5] Antibodies against adhesion molecules reduce apoptosis after transient middle cerebral artery occlusion in rat brain
    Chopp, M
    Li, Y
    Jiang, N
    Zhang, RL
    Prostak, J
    [J]. JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM, 1996, 16 (04) : 578 - 584
  • [6] CIRCULATING INTERCELLULAR-ADHESION MOLECULE-1 LEVELS AND NEUTROPHIL ADHESION IN STROKE
    CLARK, WM
    COULL, BM
    BRILEY, DP
    MAINOLFI, E
    ROTHLEIN, R
    [J]. JOURNAL OF NEUROIMMUNOLOGY, 1993, 44 (01) : 123 - 126
  • [7] Cerebral protection in homozygous null ICAM-1 mice after middle cerebral artery occlusion - Role of neutrophil adhesion in the pathogenesis of stroke
    Connolly, ES
    Winfree, CJ
    Springer, TA
    Naka, Y
    Liao, H
    Yan, SD
    Stern, DM
    Solomon, RA
    GutierrezRamos, JC
    Pinsky, DJ
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 1996, 97 (01) : 209 - 216
  • [8] Expression of inflammatory mediators and adhesion molecules in human atherosclerotic plaque
    DeGraba, TJ
    [J]. NEUROLOGY, 1997, 49 (05) : S15 - S19
  • [9] POLYMORPHONUCLEAR LEUKOCYTES OCCLUDE CAPILLARIES FOLLOWING MIDDLE CEREBRAL-ARTERY OCCLUSION AND REPERFUSION IN BABOONS
    DELZOPPO, GJ
    SCHMIDSCHONBEIN, GW
    MORI, E
    COPELAND, BR
    CHANG, CM
    [J]. STROKE, 1991, 22 (10) : 1276 - 1283
  • [10] CIRCULATING SELECTIN-TYPE AND IMMUNOGLOBULIN-TYPE ADHESION MOLECULES IN ACUTE ISCHEMIC STROKE
    FASSBENDER, K
    MOSSNER, R
    MOTSCH, L
    KISCHKA, U
    GRAU, A
    HENNERICI, M
    [J]. STROKE, 1995, 26 (08) : 1361 - 1364