Effect of vitamin E supplementation on circulating cell adhesion moleculespre- and post-coronary angioplasty

The soluble adhesion molecules P-selectin (sP-selectin) and intercellular a dhesion molecule-1 (sICAM-1) are derived from platelets and endothelial cel ls. Circulating concentrations of these soluble adhesion molecules are rais ed in patients with atherosclerosis and following percutaneous transluminal coronary angioplasty (PTCA). We have investigated the effects of vitamin E supplements (800 IU/day) on circulating plasma ICAM-1 and P-selectin level s pre- and post-PTCA. Patients, randomized to group, were pre-treated with vitamin E or placebo (soybean oil) for 1 month before routine PTCA. Plasma sICAM-1 and sP-selectin were measured by enzyme-linked immunosorbent assay on blood taken immediately pre- and post-PTCA. Total protein and alpha-toco pherol were measured on the same samples. Plasma alpha-tocopherol concentra tions increased in patients receiving vitamin E: 19.1 (1.5) [mean (standard error of the mean, SEM)] mg/mL post-PTCA versus 13.9 (0.6) mg/mL pre-PTCA (n=23; P<0.01). Plasma sP-selectin and sICAM-1 levels were not significantl y increased following PTCA in the vitamin E group. Pre-angioplasty mean (SE M) plasma sP-selectin concentration in the vitamin E group was 883 (0.97) n g/mg protein; the corresponding mean post-angioplasty value was 9.34 (0.89) ng/mg protein (P=0.85). The mean (SEM) pre-angioplasty sICAM-1 concentratio n in this group was 2.18 (0.24) ng/mg protein, and was 2.20 (0.23) ng/mg pr otein following angioplasty (P = 0.84). In the placebo group (n = 24) there was a significant increase in mean (SEM) sP-selectin concentration followi ng angioplasty, from 7.48 (0.73) to 9.70 (0.78) ng/mg protein (P<0.05). The change (mean, SEM) in plasma sP-selectin concentration following angioplas ty was significantly greater for the placebo group [2.22 (0.50) ng/mg prote in] than for the group receiving vitamin E [0.50 (0.50) ng/mg protein] (P<0 .02). This difference remained significant (P<0.05) even after adjustment f or pre-angioplasty P-selectin concentrations. Mean (SEM) plasma sICAM-1 con centrations remained unchanged following angioplasty [pre-angioplasty: 2.16 (0.20) ng/mg protein; post-angioplasty: 1.97 (0.13) ng/mg protein]. Vitami n E may therefore limit platelet or endothelial activation during PTCA.