The Serum Level of Soluble Adhesion Molecules in Patients with Acute Ischemic Stroke

ABSTRACT

BACKGROUNDS: Recent experimental studies demonstrate massive leukocytes extravasation at sites of cerebral ischemia even with the first hours of disease. Leukocytes are now considered to potentiate ischemic neural damage by microvasculature obstruction and generation of neurotoxic substances. Adhesion molecules mediate adhesion between endothelial cells and leukocytes as a precondition for extravasation of leukocytes at sites of tissue injury. We conducted a prospective study to investigate the serum level of ICAM-1, P-selectin, and E-selectin in patients with acute ischemic stroke, and with atherosclerosis. METHODS: Serum was sampled from patients within 24 hrs of acute ischemic stroke(n=20), from patients with previous (> 1 month) transient or persistent ischemic neurologic deficit associated with atherosclerosis(n=22), and control patients without a history of vascular disease(n=20). Concentrations of soluble ICAM-1(sICAM-1), P-selectin(sP-selectin), and E-electin(sE-selectin) were measured by enzyme-linked immunosorbent assay(ELISA). RESULTS: Compared with control subjects, sICAM-1 and sE-selectin were significantly elevated in patients with acute ischemic stroke and in previous symptomatic atherosclerosis(p=0.0001 and p=0.004). The serum level of sP-selectin in patients with acute ischemic stroke was higher than that in patients with previous symptomatic atherosclerosis and control subjects(p=0.0004). CONCLUSIONS: The results suggest a chronic elevation of ICAM-1 and E-selectin in patients with previous symptomatic atherosclerosis and also acute changes of them in patients with acute ischemic stroke. These findings indicate that acute changes of serum P-selectin occurred in response to acute ischemic stroke.