Soluble Intercellular Adhesion Molecule-1 And Soluble Vascular Cellular Adhesion Molecule-1 In Coronary Heart Disease

Background: Recent studies provide evidence that atherosclerosis is an inflammation within arterial wall, and an inflammatory reaction plays an important role in the appearance and development of the atherosclerotic lesion . The inflammatory process of coronary arterial atherosclerosis results in plaque formation and rupture, thrombus formation and resulting events of coronary heart disease(CHD). The inflammatory process is associated with the expression of adhesion molecules such as intercellular adhesion molecule(ICAM-l) and vascular cellular adhesion molecule (VCAM-1) at the surface of endothelial cells. These molecules interact with leukocyte integrins and promote the atherosclerotic lesion . The role of ICAM-1 and VCAM-1 in the development of atherosclerotic lesion is suggested by the demonstration of their presence in these lesions . Circulating forms of adhesion molecules are generated by cleavage to a site close to membrane insertion . The amount of soluble adhesion molecule has been demonstrated to be directly correlated with the surface expression of adhesion molecule in endothelial cells . Circulating levels of soluble adhesion molecule reflect the degree of current tissue damage. Cell adhesion molecules remain elevated at concentrations after events of CHD, indicating sustained inflammation of the atherosclerotic lesion . But it is incompletely claer what the relationship of ICAM-1 and VCAM-1 with CHD is.Aim: In order to find out the relationship between cell adhesion molecules and CHD, we measured the levels of sICAM-1 and sVCAM-1 in various typies of CHD, evaluated the correlation between the level of them and the degree of stenosis, and acquired the relationship between the level of them and stability of plaque.Methods: In oue study , 89 patients were selected and divided into 4 groups:Acute myocardial infarction(AMI) group(n=20), unstable angina pectoris(UAP) group(n=38), stable angina pectoris(SAP) group(n=16), and control(n=15). Plasma levelsof sICAM-1 and sVCAM-1 were measured separately by means of enzyme-linkedimmunosorbent assay (ELISA), in contrary to coronary angiographyResults: The levels of sICAM-1 were significantly higher in AMI group[(318.0±86.4)μg.L-1] and UAP group [(334.9±122.6)μg.L-1] than those in SAP group [(264.8±86.6)μ/g.L-1] and in control group [(279.8±145.8)μg.L-1](P<0.01). The levels of sVCAM-1 were significantly higher in AMI group [(407.8±182.1)μg.L-1], UAP group [(446.3±160.4)μg.L-1] and SAP group [(386.5±104.2)μg.L-1] than that in control group [(307.7±23.2)μg.L-1](P<0.05).The level of both sICAM-l(r=0.415) and sVCAM-l(r=0.487) were positively correlated with the degree of coronary artery stenosis (P<0.01).Conclution: Plasma levels of sICAM-1 may reflect the unstable condition of plaque in ACS patients, and the level of both sICAM-1 and sVCAM-1 can evalue the degree of stenosis of coronary artery.