Plasma level of sICAM-1 is associated with the extent of white matter lesion among asymptomatic elderly subjects.
Level 4 - case-series / case-control
Cross-sectional observational study evaluating biomarker associations with imaging findings
PubMed 19825506 · doi:10.1016/j.clineuro.2009.08.018
What was done
Researchers evaluated 175 neurologically asymptomatic individuals aged 60 years or older to assess the relationship between plasma soluble intercellular adhesion molecule-1 (sICAM-1) and white matter lesions (WML). Subcortical deep white matter hyperintensity (SDWMH) and periventricular hyperintensity (PVH) were rated separately on brain imaging and graded into three groups (grade 0–I, grade II, grade III) using the Fazekas scale. Multivariate analysis was conducted to determine independent risk factors.
What was found
Plasma sICAM-1 concentrations increased across lesion severity grades for both SDWMH (297.4 ± 135.6 ng/mL in grade 0–I, 391.3 ± 145.5 ng/mL in grade II, and 450.2 ± 232.9 ng/mL in grade III; p < 0.001) and PVH (282.5 ± 116.5 ng/mL in grade 0–I, 402.3 ± 160.4 ng/mL in grade II, and 428.1 ± 227.7 ng/mL in grade III; p < 0.001). Multivariate analysis identified sICAM-1, age, and hypertension as independent risk factors for WML. Participants in the highest sICAM-1 quartile had elevated odds for all WML (OR = 4.694, 95% CI: 1.805–12.204), moderate WML (OR = 4.618, 95% CI: 1.543–13.825), and severe WML (OR = 4.893, 95% CI: 1.236–19.368).
Why it matters
This study provides human evidence linking systemic endothelial inflammatory activation with the presence and severity of subclinical cerebral small-vessel disease.
Limits
The study is cross-sectional, precluding causal inferences regarding whether endothelial activation precedes or results from vascular damage. The sample size is modest (n = 175), confidence intervals for risk estimates are wide, and potential unmeasured confounders beyond age and hypertension were not detailed in the abstract.
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