NEUTROPHIL ANTIADHESION THERAPY FOR MYOCARDIAL-ISCHEMIA - CLINICAL POTENTIAL

Myocardial ischaemia remains a significant cause of morbidity and mortality due both to the initial ischaemic insult and also to subsequent reperfusion injury. Inflammatory mediators contribute to this phenomenon by a humoral cascade directly affecting myocytes, as well as by a cellular cascade activating the interactions between neutrophils, endothelial cells and myocytes. Investigation of these cellular interactions reveals a complex process of adhesion molecule expression with subsequent recruitment and activation of neutrophils to the site of ischaemia-induced inflammation. Understanding of mechanisms of cellular activation and interaction is advancing rapidly, and its applications are being recognised to have significant clinical potential. Although therapeutic interventions directed against the ischaemia/reperfusion phenomenon have traditionally involved modification of the insult, future therapeutics may more effectively target adhesion molecule expression or availability, thus modifying the creation of the injury.