Cell adhesion molecules - can they be used to predict coronary artery disease in patients with familial hypercholesterolaemia?

Adhesion of leukocytes to endothelial cells via cell adhesion molecules (CA MS) is thought to be pivotal in the initiation of atherosclerosis. As patie nts with familial hypercholesterolaemia (FH) are known to develop severe, p remature coronary artery disease (CAD), we investigated the usefulness of s oluble forms of CAMS namely vascular cellular adhesion molecule-1 (VCAM), i ntercellular cell adhesion molecule-1 (ICAM) and E-selectin as predictive m arkers of the presence and severity of atherosclerosis in this patient grou p. Twenty heterozygous FH patients without CAD; 24 heterozygous FH patients with CAD; 17 homozygous FH patients without documented CAD; nine homozygou s FH patients with overt CAD; and 50 healthy controls were studied. Carotid artery intima media thickness (IMT) was also measured in the homozygous pa tients. Levels of the adhesion molecules VCAM, ICAM and E-selectin were not significantly elevated in homozygous FH patients and heterozygous FH patie nts, both with and without CAD, compared to the normal control subjects. In addition the range of results was so wide and the overlap of values with n ormal controls so great, that the use of an individual level of either VCAM , ICAM or E-selectin was not predictive of either the presence or degree of atherosclerosis in the FH subjects. (C) 2000 Elsevier Science B.V. All rig hts reserved.