Adhesion molecule expression in symptomatic and asymptomatic carotid stenosis.
BACKGROUND
Prior studies have suggested a central role for cellular adhesion molecules (CAMs) in the pathophysiology and symptoms of atherosclerotic carotid plaques (CPs).


OBJECTIVE
This study examined the role of CAMs in symptom generation in patients with advanced carotid artery disease.


METHODS
Ninety-two consecutive patients underwent carotid endarterectomy, six for both sides (54 symptomatic and 41 asymptomatic CPs). Intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), P-selectin, and E-selectin were immunostained in fresh-frozen CP specimens and examined semiquantitatively in the endothelium and intima-media. Plasma concentrations of soluble ICAM-1 and sVCAM-1 were analyzed by ELISA.


RESULTS
Endothelial expression of ICAM-1, VCAM-1, P-selectin, and E-selectin did not differ between symptomatic and asymptomatic CPs, but endothelial ICAM-1 was associated with serum sensitized C-reactive protein levels (p = 0.026). However, there was less ICAM-1 expression in the intima-media of the symptomatic CPs (p = 0.022), and there was a similar, but nonsignificant tendency for VCAM-1. Soluble ICAM-1 and soluble VCAM-1 were not associated with the symptom status.


CONCLUSIONS
In contrast to earlier studies, it was found that symptomatic carotid disease is not associated with increased expression of adhesion molecules in the endothelium of advanced carotid plaques or in circulation. Rather, there was less expression of adhesion molecules in the intima-media of symptomatic carotid plaques.
Nuotio
K
K
Neuroscience Program, Biomedicum Helsinki, Finland. Krista.Nuotio@Hus.fi
Lindsberg
P J
PJ
Carpén
O
O
Soinne
L
L
Lehtonen-Smeds
E M P
EM
Saimanen
E
E
Lassila
R
R
Sairanen
T
T
Sarna
S
S
Salonen
O
O
Kovanen
P T
PT
Kaste
M
M
D000368:Aged; D020757:Amaurosis Fugax / Q000209:etiology* / Q000378:metabolism; D002097:C-Reactive Protein / Q000032:analysis; D016893:Carotid Stenosis / Q000150:complications / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D015815:Cell Adhesion Molecules / Q000096:biosynthesis* / Q000235:genetics / Q000502:physiology; D019040:E-Selectin / Q000096:biosynthesis / Q000235:genetics; D016894:Endarterectomy, Carotid; D004730:Endothelium, Vascular / Q000378:metabolism; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005786:Gene Expression Regulation; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000096:biosynthesis / Q000235:genetics; D002546:Ischemic Attack, Transient / Q000209:etiology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000096:biosynthesis / Q000235:genetics; D016037:Single-Blind Method; D012995:Solubility; D020521:Stroke / Q000209:etiology* / Q000378:metabolism; D017539:Tunica Intima / Q000378:metabolism; D017540:Tunica Media / Q000378:metabolism; D019010:Vascular Cell Adhesion Molecule-1 / Q000096:biosynthesis / Q000235:genetics
D015815:Cell Adhesion Molecules; D019040:E-Selectin; D019007:P-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein