Soluble intercellular adhesion molecule-1, E-selectin, vascular cell adhesion molecule-1 and von Willebrand factor in stroke

We investigated the role of endothelial cell and leukocyte adhesion in the pathophysiology of acute stroke. The immunocytochemical expression of adhes ion molecules in brain tissue from six patients who died following acute is chaemic stroke showed weak endothelial expression of intercellular adhesion molecule-1 (ICAM-1), but intense expression of vascular cell adhesion mole cule-1 (VCAM-1) by astrocytes and endothelial cells from the infarcted, but not the non-infarcted areas. We also measured soluble adhesion molecules E -selectin, ICAM-1, VCAM-1 and von Willebrand factor (all by enzyme-linked i mmunosorbent assay) in 21 patients after an acute ischaemic stroke (ictus < 12 h), and again 3 months later. Blood levels in the stroke patients were c ompared with 82 healthy controls and 22 subjects with carotid atheroscleros is. Compared with healthy controls, both patient groups had raised levels o f von Willebrand factor (P < 0.02) but the level of soluble VCAM-1 was rais ed only in patients with acute stroke (P < 0.02). Levels of von Willebrand factor and soluble VCAM-1 in the stroke patients were still high at 3 month s fellow-up. We suggest that there might be changes in adhesion molecule ex pression and release in the acute and chronic stages of ischaemic stroke, w here blood levels are related to immunocytochemical findings on infarcted b rain. These changes may perhaps be part of the complex pathophysiological r esponses to infarction and repair of brain tissue following stroke. Blood C oag Fibrinol 10:277-284 (C) 1999 Lippincott Williams & Wilkins.