Soluble adhesion molecules in clinical ischaemic injury.
BACKGROUND
Neutrophil adhesion is a prerequisite for ischaemic injury. In vitro research has shown that soluble adhesion molecules have an inhibitory effect on neutrophil binding


OBJECTIVE
To determine whether the circulating forms of adhesion molecules are consumed during skeletal muscle ischaemic injury in man.


METHODS
The response of the circulating forms of adhesion molecules ICAM-1 (intercellular adhesion molecule-1) and L-selectin to ischaemia and reperfusion was investigated in 23 patients during surgery involving aortic cross-clamping and in 20 volunteers with tourniquet-induced forearm ischaemia.


RESULTS
In the aortic model the levels of circulating ICAM-1 fell from an initial value of 250 +/- 20 to 210 +/- 13 ng/ml (p < 0.05) and soluble L-selectin fell from 642 +/- 62 to 487 +/- 49 ng/ml during ischaemia (p < 0.05). There was a similar pattern of reduced levels of circulating adhesion molecules in the model of forearm ischaemia. However the recovery of these molecules during the reperfusion period differed between the two models.


CONCLUSIONS
Soluble L-selectin and soluble ICAM-1 appear to be utilised during clinical models of ischaemia. This supports previous in vitro studies suggesting a role in competitive inhibition and these circulating molecules may be clinically important inhibitors of leukocyte adhesion.
Kirkpatrick
U J
UJ
Institution Vascular Studies Unit, University Hospital of South Manchester, Nell Lane, Manchester M20 8LR.
Blann
A D
AD
Adams
R A
RA
McCollum
C N
CN
D000368:Aged; D001011:Aorta / Q000601:surgery; D005542:Forearm / Q000098:blood supply*; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D007511:Ischemia / Q000097:blood* / Q000209:etiology; D019041:L-Selectin / Q000097:blood*; D008875:Middle Aged; D008954:Models, Biological; D015427:Reperfusion Injury / Q000097:blood*; D013997:Time Factors; D014111:Tourniquets / Q000009:adverse effects*
D018799:Intercellular Adhesion Molecule-1; D019041:L-Selectin