Elevated levels of soluble intercellular adhesion molecule-1 in the coronary circulation of patients with coronary organic stenosis and spasm

The cell surface expression of intercellular adhesion molecule-1 (ICAM-1) i s upregulated following activation during inflammatory responses, mediating both cell migration and activation. The involvement of inflammation in uns table angina is suggested by the presence of activated circulating leukocyt es. To examine whether plasma soluble ICAM-1 (sICAM-1) levels increase in t he coronary circulation of patients, with coronary organic stenosis and cor onary spasm, plasma sICAM-1 levels were measured in the coronary sinus (CS) and the aortic root (Ao) simultaneously in 10 patients with 90% or more co ronary narrowing and coronary spasm (coronary spastic angina (CSA) with org anic stenosis), in 11 patients with coronary spasm and no significant coron ary narrowing (CSA without organic stenosis), in 16 patients with stable ex ertional angina, and in 13 control subjects. The plasma sICAM-1 levels (ng/ ml) in the CS increased in CSA with organic stenosis (230+/-26) as compared with CSA without organic stenosis (158+/-14), stable exertional angina (13 0+/-9) and control subjects (121+/-10) (p<0.01). The levels in the Ao also increased in CSA with organic stenosis (208+/-24) as compared with CSA with out organic stenosis (149+/-13), stable exertional angina (130+/-11) and co ntrol subjects (121+/-10) (p<0.01). Furthermore, the plasma sICAM-1 levels were higher in the CS than in the Ao only in CSA with organic stenosis. The se results suggest that activation of leukocytes occurs through the inducti on of ICAM-1 in the coronary circulation in the patients with CSA with orga nic stenosis.