Frijns C J, Kappelle L J, van Gijn J, Nieuwenhuis H K, Sixma J J, Fijnheer R
Department of Neurology, University Hospital Utrecht, Netherlands.
Stroke. 1997 Nov;28(11):2214-8. doi: 10.1161/01.str.28.11.2214.
Activation of endothelial cells and platelets plays an important role in the development of atherosclerosis and thrombotic disorders. Soluble adhesion molecules originating from these cells can be demonstrated in plasma. We hypothesized that elevated plasma concentrations of soluble P-selectin (sP-selectin), soluble intercellular adhesion mole-cule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and soluble E-selectin (sE-selectin) can reflect activation of endothelial cells and/or platelets in acute ischemic stroke and in previously symptomatic internal carotid artery stenosis.
Plasma was sampled from patients within 2 days of acute ischemic stroke (n = 28), from patients with a previous (> 1 week) transient or persistent ischemic neurological deficit associated with stenosis of the internal carotid artery (n = 34), and from control patients without a history of vascular disease (n = 34). Concentrations of sP-selectin, sICAM-1, sVCAM-1, and sE-selectin were measured by means of an enzyme-linked immunosorbent assay.
Compared with control subjects, sP-selectin and sE-selectin were significantly elevated in the acute stage of ischemic stroke (P < .0001 and P = .001, respectively) as well as in previously symptomatic carotid stenosis (P < .0001 and P = .0007). sICAM-1 and sVCAM-1 were not increased.
The elevated levels of sE-selectin indicate that endothelial cell activation occurs both in the acute stage of ischemic stroke and in previously symptomatic carotid atherosclerosis. Increased sP-selectin concentrations reflect endothelial cell activation as well but may also be caused by platelet activation.
内皮细胞和血小板的激活在动脉粥样硬化和血栓形成性疾病的发展中起重要作用。源自这些细胞的可溶性黏附分子可在血浆中检测到。我们推测，血浆中可溶性P-选择素（sP-选择素）、可溶性细胞间黏附分子-1（sICAM-1）、可溶性血管细胞黏附分子-1（sVCAM-1）和可溶性E-选择素（sE-选择素）浓度升高可反映急性缺血性卒中以及既往有症状的颈内动脉狭窄时内皮细胞和/或血小板的激活。
在急性缺血性卒中患者发病2天内（n = 28）、既往（> 1周）有与颈内动脉狭窄相关的短暂性或持续性缺血性神经功能缺损的患者（n = 34）以及无血管疾病史的对照患者（n = 34）中采集血浆。采用酶联免疫吸附测定法测量sP-选择素、sICAM-1、sVCAM-1和sE-选择素的浓度。
与对照组相比，缺血性卒中急性期（分别为P <.0001和P =.001）以及既往有症状的颈动脉狭窄患者（P <.0001和P =.0007）的sP-选择素和sE-选择素显著升高。sICAM-1和sVCAM-1未升高。
sE-选择素水平升高表明内皮细胞激活发生在缺血性卒中急性期以及既往有症状的颈动脉粥样硬化中。sP-选择素浓度升高也反映内皮细胞激活，但也可能由血小板激活引起。
