Levels of soluble adhesion molecules are elevated in the cerebrospinal fluid of children with moyamoya syndrome.
OBJECTIVE
The pathogenesis of moyamoya syndrome is unknown; however, previous studies suggested an inflammatory component. Because adhesion molecules mediate inflammation during cerebral ischemia, we measured the levels of soluble isoforms of the endothelial adhesion molecules vascular cell adhesion molecule Type 1, intercellular adhesion molecule Type 1, and E-selectin in serum and cerebrospinal fluid (CSF) samples from children with moyamoya syndrome.


METHODS
Serum and CSF samples were obtained from children with moyamoya syndrome (n = 20) and patients with congenital spinal deformities (n = 20). Soluble vascular cell adhesion molecule Type 1, intercellular adhesion molecule Type 1, and E-selectin levels were measured in enzyme-linked immunoassays. The correlation between the levels of soluble adhesion molecules and the Suzuki angiographic classification was analyzed. CSF/serum albumin index values were also measured, to determine the integrity of the blood-brain barrier.


RESULTS
Compared with the control group, children with moyamoya syndrome exhibited significantly elevated CSF levels of soluble vascular cell adhesion molecule Type 1, intercellular adhesion molecule Type 1, and E-selectin. The albumin index for the moyamoya group was 9, which was significantly higher than that for the control group. However, there were no differences in the serum levels of the three soluble adhesion molecules and no correlations between age, Suzuki classification, and serum and CSF levels of adhesion molecules.


CONCLUSIONS
Our study demonstrates increased CSF levels of soluble endothelial adhesion molecules, suggesting that children with moyamoya syndrome have ongoing central nervous system inflammation, with slight impairment of the blood-brain barrier. These soluble adhesion molecules may be clinically useful as indicators of this inflammatory process and may provide some insight into this enigmatic disease process.
Soriano
Sulpicio G
SG
Department of Anesthesia Anesthesia and Critical Care Laboratory, Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA. sulpicio.soriano@tch.harvard.edu
Cowan
Douglas B
DB
Proctor
Mark R
MR
Scott
R Michael
RM
D001139:Arnold-Chiari Malformation / Q000097:blood / Q000134:cerebrospinal fluid; D002648:Child; D002675:Child, Preschool; D019040:E-Selectin / Q000097:blood / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D007223:Infant; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood / Q000134:cerebrospinal fluid*; D008297:Male; D009072:Moyamoya Disease / Q000097:blood / Q000134:cerebrospinal fluid*; D009436:Neural Tube Defects / Q000097:blood / Q000134:cerebrospinal fluid; D009994:Osmolar Concentration; D012709:Serum Albumin / Q000032:analysis; D012995:Solubility; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood / Q000134:cerebrospinal fluid*
D019040:E-Selectin; D012709:Serum Albumin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1