Mizia-Stec Katarzyna, Zahorska-Markiewicz Barbara, Mandecki Tadeusz, Janowska Joanna, Szulc Andrzej, Jastrzebska-Maj Ewa
Department of Pathiophysiology, Department of Cardiology, Silesian University School of Medicine, Ziolowa Street 45/47, 40 635, Katowice, Poland.
Int J Cardiol. 2002 May;83(2):143-50. doi: 10.1016/s0167-5273(02)00032-3.
Adhesion molecules have been suggested as mediators of atherosclerotic inflammatory process. They may contribute to the pathogenesis of stable and unstable angina.
The study group consisted of 59 patients with coronary artery disease: 27 patients with stable exertional angina (group A), 32 patients with unstable angina (group B). 20 healthy persons acted as controls (group C). Serum levels of soluble Intercellular Adhesion Molecule 1 (sICAM-1), Vascular Cell Adhesion Molecule 1 (sVCAM-1), sE-selectin, sP-selectin were measured both before and after the treadmill ECG stress test in groups A and C. In group B the measurements were carried out at 6, 24, and 48 hours following an episode of chest pain.
There were no differences between the baseline serum levels of adhesion molecules as determined in groups A and C. In patients with stable angina, the post-exercise concentrations of sE-selectin were significantly higher (68.8+/-29 ng/ml) in comparison to both baseline- (38.7+/-15 ng/ml), and group C-values (pre-exercise: 35.1+/-16; post-exercise: 49.9+/-15 ng/ml). In unstable patients, serum sP-selectin (190.1+/-99 ng/ml) and sVCAM-1 levels (1359+/-299 ng/ml) were higher when compared to those found in groups A (142.3+/-24; 962+/-352 ng/ml, respectively) and C (136.4+/-33; 851+/-168 ng/ml, respectively).
Serum levels of soluble adhesion molecules in patients with stable angina are comparable to those of healthy persons. Stress test-induced increase of sE-selectin concentration may reflect endothelial response to exercise. Unstable angina is characterized by significant elevation of sP-selectin and sVCAM-1 serum levels which seems to be related to enhanced platelets and leukocytes activation.
粘附分子被认为是动脉粥样硬化炎症过程的介质。它们可能在稳定型和不稳定型心绞痛的发病机制中起作用。
研究组由59例冠心病患者组成:27例稳定型劳力性心绞痛患者(A组),32例不稳定型心绞痛患者(B组)。20名健康人作为对照组(C组)。在A组和C组中,于平板运动心电图负荷试验前后测定血清可溶性细胞间粘附分子1(sICAM-1)、血管细胞粘附分子1(sVCAM-1)、sE-选择素、sP-选择素水平。在B组中,于胸痛发作后6、24和48小时进行测量。
A组和C组测定的粘附分子基线血清水平无差异。在稳定型心绞痛患者中,运动后sE-选择素浓度(68.8±29 ng/ml)与基线水平(38.7±15 ng/ml)及C组值(运动前:35.1±16;运动后:49.9±15 ng/ml)相比均显著升高。在不稳定型患者中,血清sP-选择素(190.1±99 ng/ml)和sVCAM-1水平(1359±- 299 ng/ml)高于A组(分别为142.3±24;962±352 ng/ml)和C组(分别为136.4±33;851±168 ng/ml)。
稳定型心绞痛患者血清可溶性粘附分子水平与健康人相当。负荷试验诱导的sE-选择素浓度升高可能反映内皮对运动的反应。不稳定型心绞痛的特征是sP-选择素和sVCAM-1血清水平显著升高,这似乎与血小板和白细胞活化增强有关。