Selaković Vesna, Colić Miodrag, Jovanović Marina, Raicević Ranko, Jovicić Aco
Military Medical Academy, Institute of Medical Research, Belgrade.
Vojnosanit Pregl. 2003 Mar-Apr;60(2):139-46. doi: 10.2298/vsp0302139s.
Leukocyte migration into the ischemic area is a complex process, controlled by adhesion molecules (AM) in leukocytes and endothelium, by migratory capacity of leukocytes and the presence of hemotaxic agents in the tissue. In this research it was supposed that in the blood and cerebrospinal fluid (CSF) of patients in the acute phase of ischemic brain disease (IBD) there were relevant changes in the concentration of soluble AM (sICAM-1, sVCAM-1 and sE-selectin), that could have been the indicators of the intensity of damaging processes in central nervous system (CNS).
The study included 45 IBD patients, 15 with transient ischemic attack (TIA), 15 with reversible ischemic attack (RIA), and 15 with brain infarction (BI), of both sexes, mean age 66 +/- 7. Control group consisted of 15 patients with radicular lesions of discal origin, subjected to diagnostic radiculography, without the signs of interruption in the passage of CSF. Changes of selected biochemical parameters were determined in all patients in frame 72 hours since the occurrence of an ischemic episode. Concentrations of soluble AM were determined in plasma and CSF by ELISA. Total number of leukocytes (TNL) in peripheral blood was determined by hematological analyzer.
The results showed that during the first 72 hrs of IBD significant increases occurred in TNL and that the increase was progressive compared to the severeness of the disease. Significant increase of soluble AM concentration was shown in plasma of IBD patients. The increase was highest in BI, somewhat lower in RIA and the lowest in TIA patients compared to the control. In CSF concentrations of sICAM-1, sVCAM-1 and sE-selectin demonstrated similar increasing trend as in plasma.
TNL, as well as the soluble AM concentrations in plasma and CSF, were increased during the acute IBD phase and progressive in relation to the severeness of the disease, so that they might have been the indicators of CNS inflammatory reaction intensity. Furthermore, the results indicated their role in IBD pathogenesis and offered the possibility of researching the application of antagonists and/or activity modulators of some of them in IBD therapy.
白细胞迁移至缺血区域是一个复杂的过程，受白细胞和内皮细胞中的黏附分子（AM）、白细胞的迁移能力以及组织中趋化因子的存在所控制。本研究推测，在缺血性脑疾病（IBD）急性期患者的血液和脑脊液（CSF）中，可溶性AM（sICAM - 1、sVCAM - 1和sE - 选择素）的浓度会发生相关变化，这些变化可能是中枢神经系统（CNS）损伤过程强度的指标。
该研究纳入了45例IBD患者，其中15例为短暂性脑缺血发作（TIA），15例为可逆性缺血发作（RIA），15例为脑梗死（BI），男女均有，平均年龄66±7岁。对照组由15例椎间盘源性神经根病变患者组成，接受诊断性神经根造影，无脑脊液通路中断的迹象。在缺血发作后72小时内，测定所有患者选定的生化参数变化。通过酶联免疫吸附测定法（ELISA）测定血浆和脑脊液中可溶性AM的浓度。用血液分析仪测定外周血白细胞总数（TNL）。
结果显示，在IBD的最初72小时内，TNL显著增加，且与疾病严重程度相比呈进行性增加。IBD患者血浆中可溶性AM浓度显著增加。与对照组相比，BI患者的增加最高，RIA患者略低，TIA患者最低。脑脊液中sICAM - 1、sVCAM - 1和sE - 选择素的浓度显示出与血浆相似的增加趋势。
在IBD急性期，TNL以及血浆和脑脊液中的可溶性AM浓度均升高，且与疾病严重程度呈进行性相关，因此它们可能是CNS炎症反应强度的指标。此外，结果表明它们在IBD发病机制中的作用，并为研究其中一些拮抗剂和/或活性调节剂在IBD治疗中的应用提供了可能性。
