NEUTROPHIL ANTIADHESION THERAPY FOR MYOCARDIAL-ISCHEMIA - CLINICAL POTENTIAL

Myocardial ischaemia remains a significant cause of morbidity and mort ality due both to the initial ischaemic insult and also to subsequent reperfusion injury. Inflammatory mediators contribute to this phenomen on by a humoral cascade directly affecting myocytes, as well as by a c ellular cascade activating the interactions between neutrophils, endot helial cells and myocytes. Investigation of these cellular interaction s reveals a complex process of adhesion molecule expression with subse quent recruitment and activation of neutrophils to the site of ischaem ia-induced inflammation. Understanding of mechanisms of cellular activ ation and interaction is advancing rapidly, and its applications are b eing recognised to have significant clinical potential. Although thera peutic interventions directed against the ischaemia/reperfusion phenom enon have traditionally involved modification of the insult, future th erapeutics may more effectively target adhesion molecule expression or availability, thus modifying the creation of the injury.