Adhesion molecules in cerebrovascular diseases - Evidence for an inflammatory endothelial activation in cerebral large- and small-vessel disease

Background and Purpose-Adhesion molecules mediate attachment and transendot helial migration of leukocytes as a critical step in pathogenesis of athero sclerosis. Their expression and release were comparatively investigated in patients with large- and small-vessel disease of the central nervous system . Methods-With immunological methods, serum concentrations of endothelial-der ived adhesion molecules (soluble endothelial-leukocyte adhesion molecule [s E-selectin], soluble vascular-leukocyte adhesion molecule-1, and soluble in tercellular adhesion molecule-1 [sICAM-1]) were quantified in patients with obstructive disease of extracranial (n=89) and intracranial (n=20) large-v essel disease and patients with subcortical vascular encephalopathy (n=64), a cerebral small-vessel disease. As controls, age- and sex-matched subject s without obstructive cerebrovascular disease (n=67) were studied. Results-We observed significantly increased serum concentrations of sE-sele ctin and sICAM-1 in patients with both obstructive disease of the large bra in-supplying arteries and subcortical vascular encephalopathy. Interestingl y, the highest levels were observed in intracranial macroangiopathy. Furthe rmore, concentrations of sICAM-1 and sE-selectin were significantly increas ed in current smokers but not in diabetic or hypertensive patients. Conclusions-The observation of elevated release of endothelial-derived adhe sion molecules in both patients with stenoses of the large brain-supplying arteries and patients with subcortical vascular encephalopathy indicates th at inflammatory endothelial activation and adhesion of leukocytes play simi larly important roles in cerebral large- and small-vessel disease.