Pellegatta F, Pizzetti G, Lu Y, Radaelli A, Pomes D, Carlino M, Meloni C, Belotti G, Galli L, Vidal M J, Chierchia S L
Laboratory of Cadiovascular Pathophysiology, Istituto Scientifico San Raffaele, Milan, Italy.
J Cardiovasc Pharmacol. 1997 Oct;30(4):455-60. doi: 10.1097/00005344-199710000-00008.
Previous studies have shown that adhesion molecules play a crucial role in leukocyte-endothelium interactions that occur during myocardial ischemia and reperfusion. We assessed the plasma levels of the soluble form of E-selectin (sE-selectin) and intercellular adhesion molecule-1 (sICAM-1) in 15 patients with acute myocardial infarction (AMI) and in 15 controls with chronic stable angina. In patients with AMI, the levels of sE-selectin and sICAM-1 increased significantly during the first 8 h after infarction and subsequently decreased. Soluble E-selectin levels were inversely related to the peak plasma levels of creatine kinase-MB (CK-MB), and the time course of their appearance in plasma correlated with that of neutrophil count and plasma D-dimer. In individual patients, peak and mean sICAM-1 levels correlated respectively with plasma D-dimer concentrations and monocyte count, but no correlation were found when their time courses were analyzed. Eight hours after symptom onset, the mean plasma sE-selectin levels were higher in patients with AMI than in those with stable angina, whereas no significant differences were found in mean plasma sICAM-1 levels between the two groups at every time analyzed. In the acute phase of MI (a) sE-selectin and sICAM-1 levels increase during the first 8 h and subsequently decrease; (b) the increase in sE-selectin probably reflects activation of endothelial cells, correlates with other inflammatory and coagulation parameters, and is inversely related to the degree of myocardial damage; and (c) sICAM-1 plasma levels do not represent a good marker of "cell activation" because they reflect activation of different cells and may be affected by different conditions.
先前的研究表明，黏附分子在心肌缺血和再灌注期间发生的白细胞-内皮细胞相互作用中起关键作用。我们评估了15例急性心肌梗死（AMI）患者和15例慢性稳定型心绞痛对照者血浆中可溶性E-选择素（sE-选择素）和细胞间黏附分子-1（sICAM-1）的水平。在AMI患者中，梗死发生后的最初8小时内sE-选择素和sICAM-1水平显著升高，随后下降。可溶性E-选择素水平与肌酸激酶-MB（CK-MB）的血浆峰值水平呈负相关，其在血浆中出现的时间进程与中性粒细胞计数和血浆D-二聚体的时间进程相关。在个体患者中，sICAM-1的峰值和平均水平分别与血浆D-二聚体浓度和单核细胞计数相关，但分析其时间进程时未发现相关性。症状发作8小时后，AMI患者的平均血浆sE-选择素水平高于稳定型心绞痛患者，而在每次分析时两组之间的平均血浆sICAM-1水平均未发现显著差异。在心肌梗死急性期：（a）sE-选择素和sICAM-1水平在最初8小时内升高，随后下降；（b）sE-选择素的升高可能反映内皮细胞的激活，与其他炎症和凝血参数相关，并且与心肌损伤程度呈负相关；（c）sICAM-1血浆水平不是“细胞激活”的良好标志物，因为它们反映不同细胞的激活，并且可能受不同条件影响。
