CIRCULATING SELECTIN-TYPE AND IMMUNOGLOBULIN-TYPE ADHESION MOLECULES IN ACUTE ISCHEMIC STROKE

Background and Purpose Cellular adhesion molecules mediate adhesion be tween endothelial cells and leukocytes as a precondition for extravasa tion of leukocytes at sires of tissue injury. The pattern of release o f circulating adhesion molecules has been characterized in patients wi th acute ischemic stroke. Methods Serum concentrations of soluble sele ctin-type adhesion molecules (soluble endothelial leukocyte adhesion m olecule-1 [sELAM-1], soluble lymph node homing receptor [sL-selectin]) and immunoglobulin-type adhesion molecules (soluble vascular cell adh esion molecule-1 [sVCAM-1], soluble intercellular adhesion molecule-1 [sICAM-1]) were serially determined (at hours 4, 8, and 10 and at days 1, 3, and 5) in 22 patients with acute ischemic stroke. As control su bjects, age-and sex-matched individuals with (n = 40) and without (n = 22) vascular risk factors were studied. Results We observed increased concentrations of sICAM-1 and decreased levels of sL-selectin in pati ents with risk factors even in the absence of stroke. Patients with ac ute stroke had, in addition, an initial transient increase of sELAM-1 and a persistent increase of sVCAM-1. Conclusions The results suggest a chronic alteration of expression of adhesion molecules sICAM-1 and s L-selectin in subjects with risk factors for atherosclerosis; they als o indicate acute changes of levels of sELAM-1 and sVCAM-1 in response to acute ischemic stroke. Determination of soluble adhesion molecules could allow in vivo monitoring of the initial steps of leukocyte-media ted brain damage in acute ischemic stroke.