Levels of circulating adhesion molecules in congestive heart failure and after heart transplantation
Levels of circulating adhesion molecules in congestive heart failure and after heart transplantation
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DOI：
10.1016/s0002-9149(97)00972-7
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发表时间：
1998-03-01
影响因子：
2.8
通讯作者：
Aukrust, P
中科院分区：
文献类型：
--
作者：
Andreassen, AK;Nordoy, I;Aukrust, P
最近的研究表明，免疫和炎症过程在心脏移植后充血性心力衰竭（CHF）和加速性冠状动脉疾病（CAD）的发病机制中起作用。内皮细胞、白细胞和血小板之间涉及各种粘附分子的相互作用可能特别重要。34例重度心力衰竭患者血清可溶性P-选择素、可溶性E-选择素的检测（23例CAD和11例特发性扩张型心肌病）和20例健康对照，其中20例患者在HT后长达2年的时间内连续测量这些循环粘附分子（CAM），无论心力衰竭的病因如何，与对照组相比，CHF患者中所有3种CAM的水平均显著升高，sVCAM-1的浓度特别高。随着时间的推移，发现CAM中的不同模式，而HT后sE-选择素水平正常化，sVCAM-1的浓度也下降，但没有正常化。相反，sP-选择素水平持续升高，在研究期结束时浓度最高，sP-选择素的持续升高和sVCAM-1水平缺乏正常化与肿瘤坏死因子-α的血清水平持续升高有关，这些结果与同种异体移植排斥反应的急性发作或并发感染无关。这些结果支持免疫和炎症过程是CHF的重要特征的观点。此外，持续升高的CAM和肿瘤坏死因子-α水平发现HT后2年可能反映了这些患者的持续免疫激活状态，可能参与HT后CAD的发展。(C)1998年由Excerpta Medico，Inc.
Recent reports suggest a role for immunologic and inflammatory processes in the pathogenesis of congestive heart failure (CHF) and accelerated coronary artery disease (CAD) after heart transplantation (HT), The interaction between endothelial cells, leukocytes, and platelets involving various adhesion molecules may be of particular importance, We therefore measured serum levels of soluble(s) vascular cell adhesion molecule-1 (VCAM-1), sP-selectin, and sE-selectin in 34 patients with severe CHF (23 with CAD and 11 with idiopathic dilated cardiomyopathy) and in 20 healthy controls, Twenty of the patients were followed with serial measurements of these circulating adhesion molecules (CAMs) for up to 2 years after HT, Levels of all 3 CAMs were significantly elevated in patients with CHF compared with controls irrespective of the etiology of heart failure, with particularly high concentrations of sVCAM-1, After HT, different patterns in CAMs were found over time, Whereas there was a normalization of sE-selectin levels after HT, concentrations of sVCAM-1 also declined, but without normalization, In contrast, sP-selectin levels were persistently elevated, with the highest concentrations at the end of the study period, The persistent elevation of sP-selectin and the lack of normalization of sVCAM-1 levels were associated with persistently raised serum levels of tumor necrosis factor-alpha, and these findings were not related to either acute episodes of allograft rejection or intercurrent infections, These results support the notion that immunologic and inflammatory processes are important features of CHF. Furthermore, the persistently elevated levels of CAMs and tumor necrosis factor-alpha found up to 2 years after HT may reflect a state of persistent immune activation in these patients, possibly involved in the development of CAD after HT. (C) 1998 by Excerpta Medico, Inc.