Detection of soluble E-selectin, ICAM-1, VCAM-1, and L-selectin in the cerebrospinal fluid of patients after subarachnoid hemorrhage
Detection of soluble E-selectin, ICAM-1, VCAM-1, and L-selectin in the cerebrospinal fluid of patients after subarachnoid hemorrhage
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DOI：
10.3171/jns.1998.89.4.0559
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发表时间：
1998-10-01
影响因子：
4.1
通讯作者：
Lee, KS
中科院分区：
文献类型：
--
作者：
Polin, RS;Bavbek, M;Lee, KS
对象。本研究的目的是探讨蛛网膜下腔出血（SAH）后脑脊液（CSF）中可溶性粘附分子水平是否升高。已知的血管痉挛中的炎症反应和血管粘附分子在调节白细胞粘附和跨血管内皮迁移中的作用表明了这种关联。采用定量酶联免疫吸附法测定e-选择素、细胞间粘附分子-1 （ICAM-1）、血管粘附分子-1 （VCAM-1）和l -选择素，对17例近期动脉瘤性SAH患者和16例对照患者的脑脊液样本进行前瞻性分析。与正常对照、未破裂动脉瘤患者和SAH发生数月后检测的患者相比，SAH后患者脑脊液中可溶性e -选择素（p = 0.0013）、ICAM-1 （p = 0.0001）和VCAM-1 （p = 0.048）的水平升高。此外，个别患者在他们最初的发作时进行测试，表明黏附分子水平随着时间的推移而下降。e -选择素水平在后来发展为中度或重度血管痉挛的患者中最高（p = 0.044）。已知粘附分子参与白细胞粘附内皮和随后的渗出和迁移，这在组织损伤的开始中起作用。作者已经证明了三个粘附分子的提升。e -选择素水平严重升高见于后来发生血管痉挛的患者。血管粘附分子与脑血管痉挛的发病机制有关。
Object. The goal of this study was to explore whether the levels of soluble adhesion molecules were elevated in cerebrospinal fluid (CSF) after subarachnoid hemorrhage (SAH). This association was suggested by the known inflammatory response in vasospasm and the role of vascular adhesion molecules in regulating leukocytic adhesion to, and migration across, vascular endothelium.Methods. A prospective analysis was performed on CSF samples obtained in 17 patients who had suffered a recent aneurysmal SAH and in 16 control patients by using quantitative enzyme-linked immunosorbent assays for E-selectin, intercellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1), and L-selectin. Levels of soluble forms of E-selectin (p = 0.0013), ICAM-1 (p = 0.0001), and VCAM-1 (p = 0.048) were found to be elevated in the CSF of patients after SAH compared with levels in the CSF of normal controls, patients with unruptured aneurysms, and patients tested months after SAH occurred. In addition, individual patients tested at the time of their initial ictus demonstrated a fall in adhesion molecule levels over time. Levels of E-selectin (p = 0.044) were highest in patients who later developed moderate or severe vasospasm.Conclusions. Adhesion molecules are known to be involved in white cell adherence to the endothelium and subsequent diapedesis and migration in which a role in initiation of tissue damage is postulated. The authors have demonstrated the elevation of three adhesion molecules. with severely elevated levels of E-selectin seen in patients who later develop vasospasm. A correlation with a role of vascular adhesion molecules in the pathogenesis of cerebral vasospasm is suggested.