Adhesion molecules in cerebrovascular diseases. Evidence for an inflammatory endothelial activation in cerebral large- and small-vessel disease.
Level 4 - case-series / case-control
Case-control comparative study
PubMed 10436116 · doi:10.1161/01.str.30.8.1647
What was done
Researchers measured serum concentrations of endothelial-derived adhesion molecules (sE-selectin, soluble vascular-leukocyte adhesion molecule-1, and sICAM-1) using immunological methods. They compared 89 patients with extracranial large-vessel disease, 20 with intracranial large-vessel disease, and 64 with subcortical vascular encephalopathy (small-vessel disease) against 67 age- and sex-matched controls without obstructive cerebrovascular disease.
What was found
The abstract reports no numerical concentrations or exact p-values. Serum concentrations of sE-selectin and sICAM-1 were significantly increased in patients with both large-vessel disease and subcortical vascular encephalopathy compared with controls, with the highest levels observed in intracranial macroangiopathy. Concentrations of sICAM-1 and sE-selectin were also significantly increased in current smokers, but not in diabetic or hypertensive patients.
Why it matters
This paper demonstrates that inflammatory endothelial activation occurs in both cerebral large-vessel atherosclerosis and cerebral small-vessel disease, suggesting a shared inflammatory pathway.
Limits
No numerical values, variances, or p-values are reported in the abstract. The cross-sectional case-control design cannot establish whether endothelial activation is a cause or consequence of cerebrovascular disease, and the intracranial disease subgroup was small (n=20).
Cited by
- supports Patients with small vessel disease have high levels of soluble cell adhesion molecules shed from brain endothelial cells detectable in biofluids.