缬沙坦和尼群地平对原发性高血压患者血清可溶性粘附分子影响的对比研究

目的　对比研究缬沙坦和尼群地平对原发性高血压 (EH )患者血压及血清可溶性粘附分子sICAM 1,sVCAM 1水平的影响。方法　随机对照方法设计 ,将 6 4例轻中度原发性高血压患者分为两组 ,分别予缬沙坦 (80mg/d)和尼群地平 (10～ 30mg/d)治疗 6周 ,治疗前后抽血 ,用酶联免疫方法 (ELISA)测定外周血清中可溶性粘附分子sICAM 1,sVCAM 1水平。另选择 2 5例健康人作为对照组。结果　治疗前与对照组比较 ,高血压患者血清中可溶性粘附分子sICAM 1,sVCAM 1水平升高 ,分别为 [(318 2± 2 7 5 ) μg/Lvs (2 71 5± 2 6 8) μg/L ,P <0 0 5 ]和 [(5 90 6± 4 0 1) μg/Lvs (4 17 9± 38 7) μg/L ,P <0 0 1]。治疗后两组的血压均明显下降 (P <0 0 5 ) ,两组间无差异。缬沙坦组可溶性粘附分子sICAM 1,sVCAM 1水平均较治疗前明显下降 ,分别为[(32 0 5± 2 3 6 ) μg/Lvs (2 80 2± 2 5 4 ) μg/L ,P <0 0 5 ]和[(5 86 2± 4 2 5 ) μg/Lvs (4 5 1 2± 38 9) μg/L ,P <0 0 1]。而尼群地平组可溶性粘附分子sICAM 1,sVCAM 1水平较治疗前无明显下降 (P >0 0 5 )。结论　与尼群地平比较 ,缬沙坦不仅能有效降低血压 ,还能抑制血管壁的炎症反应 ,有利于预防和延缓动脉粥样硬化的发生和发展。     

脑梗死患者血清可溶性黏附分子的变化及临床意义

目的　了解急性脑梗死患者血清可溶性黏附分子的变化及临床意义。　方法　采用双抗体夹心ELISA法测定了 77例脑梗死患者血清可溶性黏附分子 ,并与 36例脑出血和 30例健康人对照比较。　结果　脑梗死患者 2 4h内血清可溶性黏附分子水平〔sICAM 1:(4 80 3± 2 6 1) μg/L ,sVCAM 1:(1197± 81) μg/L ,sELAM 1:(5 0 4 4± 2 6 9) μg/L〕明显高于脑出血和健康对照组 (P <0 0 1) ,至第 14天仍高于脑出血组和健康对照组 ;大梗死灶组血清可溶性黏附分子水平〔sICAM 1:(5 0 81± 30 4 ) μg/L ,sVCAM 1:(12 2 3± 4 9) μg/L ,sELAM 1:(5 2 4 4± 2 89) μg/L)明显高于中梗死灶组和小梗死灶组。脑梗死后并发感染患者在 14d内血清可溶性黏附分子水平明显高于无并发感染者。　结论　可溶性黏附分子与急性脑梗死密切相关 ,可溶性黏附分子可作为脑梗死治疗时 ,特别是进展性卒中治疗的重要监测指标之一。     

对氧磷酯酶1与2型糖尿病肾病的关系

目的　探讨血清对氧磷酯酶 1(PON1)活性与 2型糖尿病 (DM)并发肾病 (DN)的关系。方法　血清PON1活性用酚乙酸酯为底物测定 ,血浆氧化型低密度脂蛋白 (ox LDL)用ELISA法测定 ,尿 2 4小时微量白蛋白用放免法测定。结果　 91例 2型DM患者的PON1活性比 5 4例正常对照显著降低〔(138.2± 31.4 )kU/Lvs (184 .1± 2 9.5 )kU/L ,P <0 .0 0 1〕 ,且 2型DM的Ⅰ组 (UAER <30mg/ 2 4h)、Ⅱ组 (UAER 30～ 30 0mg/ 2 4h)和Ⅲ组 (UAER >30 0mg/ 2 4h)相比 ,PON1活性依次显著下降〔(15 1.8± 2 4 .5 )kU/L ,(12 4 .5± 32 .8)kU/L ,(10 1.1± 36 .6 )kU/L ,P <0 .0 1〕 ,而ox LDL的浓度却依次显著升高〔(6 16 .2± 135 .7) μg/L ,(75 3.9± 132 .5 ) μg/L ,(875 .1± 15 3.2 ) μg/L ,P <0 .0 1〕。PON1活性与ox LDL的浓度呈高度负相关 (r =- 0 .83,P <0 .0 0 1) ,也与UAER呈负相关 (r =- 0 .2 8,P<0 .0 5 ) ,多元回归分析表明PON1活性是 2型DM并发DN的高度危险因素 (P <0 .0 1)。结论　PON1活性在 2型DM显著下降 ,且在并发DN的 2型DM患者下降更显著。PON1活性与ox LDL呈负相关。PON1活性降低是 2型DM并发DN的高度危险因素     

糖尿病大鼠一氧化氮与骨代谢变化的研究

目的　研究糖尿病 (DM )大鼠血清一氧化氮 (NO)与早期骨代谢改变的关系。方法2 0只SD大鼠分为 2组 ,一组以链脲佐菌素诱导建立糖尿病 (STZ DM )大鼠模型 ,另一为正常对照组 ,测定 2组大鼠的空腹血糖 (FBG)、HbA1c、血清胰岛素、全身、股骨和腰椎骨密度 (BMD)、骨代谢相关指标〔血清钙、骨钙素、降钙素、甲状旁腺素 (PTH)、维生素D3 及尿吡啶酚 /肌酐比〕和血清NO水平。结果　STZ DM大鼠与正常对照组相比 ,血清NO水平显著升高〔(5 1.3± 11.9vs 38.1± 12 .0 )μmol/L ,P <0 .0 1〕 ;全身、股骨和腰椎的BMD显著降低〔(0 .15± 0 .0 7vs 0 .2 1± 0 .0 2 ) g/cm2 ,P<0 .0 1;(0 .16± 0 .0 2vs 0 .19± 0 .0 3) g/cm2 ,P <0 .0 5 ;(0 .12± 0 .0 4vs 0 .18± 0 .0 6 ) g/cm2 ,P <0 .0 5〕 ;血清钙浓度显著升高〔(135 .9± 11.3vs 117.2± 6 .5 )mg/L ,P <0 .0 0 1〕 ,骨钙素水平显著升高〔(0 .0 7± 0 .0 4vs 0 .0 5± 0 .0 1) μg/L ,P <0 .0 5〕 ,维生素D3 水平显著降低〔(7.6± 1.9vs 11.6± 4 .1)μg/L ,P <0 .0 5〕 ,尿吡啶酚 /肌酐显著降低〔(4.8± 0 .8vs 75 .8± 6 0 .7)nmol/mmolCr,P <0 .0 1〕 ;而降钙素和PTH水平改变无统计学意义。相关性分析显示 ,血清NO与尿吡啶酚排泄呈负相关 (r= - 0 .74 ,     

急性淋巴细胞白血病患儿血清sTNFRs水平测定的临床价值

目的 :探讨急性淋巴细胞白血病患儿血清 TNFa、s TNFR- 和 s TNFR- 水平及其临床意义。方法 :采用 EL ISA法测定血清 TNFa、s TNFR- 和 s TNFR- 水平。结果 :2 4例 AL L患儿血清 TNFα〔(173.2 2±74.5 1) ng/L〕明显高于 2 0例正常对照儿童〔(78.5 9± 18.45 ) ng/L〕,初发与复发患儿血清 s TNFR- 〔(2 .76±1.0 5 )、(2 .44± 1.37) μg/L〕、s TNFR- 〔(2 .33± 1.18)、(2 .0 9± 1.2 2 ) μg/L〕明显高于正常儿童〔(0 .75± 0 .2 6 )、(0 .71± 0 .14) μg/L〕,均为 P <0 .0 1;血清 TNFα与 s TNFR- 呈显著性正相关 (r =0 .6 31,P <0 .0 1) ;8例患儿经有效治疗完全缓解后血清 s TNFRs均降至正常水平〔(0 .83± 0 .2 5 )、(0 .92± 0 .17) μg/L〕;血清 s TNFRs在WBC≥ 10 0× 10 9/L患儿的阳性率明显高于 WBC<10 0× 10 9/L者 (P <0 .0 1) ,其与外周血幼稚细胞数呈显著正相关 (R =0 .72 4 ,R =0 .582 ,P <0 .0 5)。结论 :AL L患儿血清 s TNFRs异常升高与白血病细胞有关 ,血清 s TNFRs水平可作为估计肿瘤负荷及治疗效果的一项指标。     

急性心肌梗死和不稳定性心绞痛患者粘附分子及相关因素的研究

目的　探讨急性心肌梗死 (AMI)和不稳定性心绞痛 (UAP)患者发病早期和 1周可溶性细胞间粘附分子 1(sICAM 1)、可溶性血管细胞粘附分子 1(sVCAM 1)、D 二聚体、血小板第 4因子 (PF4 )的动态变化及其相互关系。方法　测定 40例AMI、45例UAP患者发病 2 4h和 1周时血清sICAM 1、sVCAM 1、D 二聚体、PF4 并与 30例对照组比较。结果　AMI和UAP患者于发病 2 4h和 1周时sICAM 1、sVCAM 1、D 二聚体、PF4 均明显高于对照组 (P<0 0 1)。AMI组中 ,溶栓再通者与未溶栓者sICAM 1、sVCAM 1、D 二聚体、PF4 比较 ,差异无显著性意义 (P>0 0 5 )。AMI溶栓组中再通后与再通前相比 ,sICAM 1、sVCAM 1、D 二聚体均明显下降 (P <0 0 5 ) ;AMI、UAP组于发病 2 4h及 1周时sICAM 1与sVCAM 1均具有正相关性 (P <0 0 1) ,PF4 与sICAM 1、sVCAM 1、D 二聚体间亦具有正相关性 (P <0 0 1)。结论　AMI、UAP从发病早期至 1周sICAM 1、sVCAM 1持续升高 ,以AMI更为明显 ,表明炎症参与心肌细胞损伤过程     

培哚普利对充血性心力衰竭患者血浆细胞间粘附因子-1的影响

目的 :探讨培哚普利对充血性心力衰竭 (CHF)患者血浆细胞间粘附因子 1(sICAM 1)水平的影响及心脏保护机制。 方法 :用酶联免疫方法检测 42例服用培哚普利的CHF患者、42例常规治疗CHF患者治疗前后及 30例健康者血浆中sICAM 1水平。 结果 :① 84例CHF患者血浆中sICAM 1为 ( 5 87.6± 15 2 .1) μg/L ,较健康者 ( 16 7.4± 34.6 ) μg/L显著增高 ( P<0 .0 0 1) ,且随着心功能损害程度加重而升高 ,各组间比较差异有显著性意义 (P <0 .0 5 )。②CHF培哚普利治疗组与常规治疗组治疗前后血浆中sICAM 1浓度〔分别为 ( 5 91.8± 15 5 .2 )、( 332 .1± 115 .8) μg/L ;( 5 80 .0± 134.4)、( 4 2 3.1± 118.1) μg/L〕水平差异有非常显著性意义 (P <0 .0 1) ,且培哚普利治疗组较常规治疗组治疗后血浆中sICAM 1降低更为明显 (P <0 .0 1)。 结论 :培哚普利具有抑制CHF患者sICAM 1水平的作用 ,从而减缓心室重塑的进程 ,保护和改善心功能。     

冠心病患者血清血管内皮生长因子水平与冠状动脉病变程度的关系

目的 :探讨冠心病 (CHD)患者血清血管内皮生长因子 (VEGF)水平与冠状动脉病变的关系。方法 :采用酶联免疫吸附法 (ELISA)检测了 12 4例经冠状动脉造影证实有一支以上主要冠状动脉狭窄≥ 5 0 %的CHD患者血清VEGF水平 ,并作相关分析。结果 :CHD组血清VEGF水平明显高于正常对照组〔(2 93.2± 12 6 .3)ng/L∶(12 0 .1± 31.5 )ng/L ,P <0 .0 1〕 ,双支和三支血管病变患者血清VEGF水平高于单支组〔(2 83.4± 85 .0 )ng/L ,(398.1± 10 5 .5 )ng/L∶ (191.7± 2 7.3)ng/L ,P <0 .0 1〕 ,随着血管狭窄程度的加重 ,血清VEGF水平升高越明显 ,两者呈显著正相关 (r =0 .78,P <0 .0 0 1) ,CHD并发高血压和 (或 )糖尿病对血清VEGF水平无显著影响 (P >0 .0 5 )。结论 :CHD患者血清VEGF水平升高 ,其升高程度与冠状动脉病变程度有良好的相关性     

促性腺激素释放激素类似物简易激发试验对性早熟诊断的评价

目的　评价促性腺激素释放激素类似物 (GnRHa)简易激发试验对性早熟的诊断价值。方法　乳房发育提前的 74例女孩 (就诊时行 0、30和 6 0min简易GnRHa激发试验 )被分为 4组 :真性性早熟 (CPP)B2 组 19例 ;CPPB3 组 2 3例 ;单纯性乳房早发育 (PT)组 2 2例 ;外周性性早熟 (PPP)组 10例。对各组激发试验进行比较和分析。结果　PPP组 3个时相血清FSH及LH浓度差异无显著性。PT、CPPB2 和CPPB3 组 3个时相的血清FSH及LH浓度差异均有显著性 (P <0 .0 1)。PT组ΔFSH(8.0± 3.2 )IU/L显著高于ΔLH〔(1.9± 1.4 )IU/L ,P <0 .0 1〕。CPPB2 组ΔFSH(7.0± 2 .9)IU/L与ΔLH(8.2± 6 .7)IU/L差异无显著性。CPPB3 组ΔLH(2 3.0± 2 2 .0 )IU/L显著高于ΔFSH〔(9.0± 4 .3)IU/L ,P <0 .0 5〕。PT、CPPB2 和CPPB3 组的ΔLH及峰LH/FSH〔(0 .4± 0 .2 )、 (1.1± 0 .8)和 (1.9± 1.7)〕差异有显著性 (P <0 .0 1)。以LH峰值≥ 4 .4IU/L和峰LH/FSH≥ 0 .4 6为前提 ,诊断CPP的灵敏度和特异度分别为 90 .5 %和 90 .9%。结论　PPP组垂体对GnRHa无应答。PT组反应以FSH升高为主 ,CPPB2 和CPPB3 组以LH升高为主。此激发试验对性早熟性质具早期鉴别诊断价值     

HBVDNA的表达与肝纤维化形成的相关性研究

探讨HBVDNA的表达与肝纤维化形成的相关性。应用荧光定量PCR技术测定 2 0 0例乙肝患者和 4 9名健康对照组的血清HBVDNA ,同时用放免法检测层粘连蛋白 (LN)、透明质酸 (HA)、Ⅲ型前胶原 (PⅢ )、Ⅳ型胶原 (Ⅳ .C)水平。HBVDNA表达阳性组LN、HA、PⅢ、Ⅳ .C的含量〔(16 4 8± 5 6 1)、(16 6 1± 78 0 )、(15 3 5± 6 0 7)、(92 1±2 9 9) μg/L〕显著高于HBVDNA阴性组〔(110 9± 2 9 8)、(82 1± 2 4 7)、(91 9± 2 9 2 )、(5 9 5± 14 3) μg/L〕(P <0 0 0 1)和健康对照组〔(10 4 9± 16 3)、(6 8 0± 2 7 6 )、(76 3± 2 1 3)、(5 4 3± 7 8) μg/L〕(P <0 0 0 1)。HBVDNA阳性组中 ,上述四项指标随着HBVDNA含量升高而递增。动态观察 2 8例乙肝患者随着治疗过程HBVDNA浓度下降 ,LN、HA、PⅢ、Ⅳ .C的含量明显递减。HBVDNA的阳性表达与肝纤维化形成的相关性十分密切     

胃肿瘤患者循环可溶性细胞间粘附分子-1和血管细胞粘附分子-1

AIM To elucidate the biological and clinical significance of sICAM-1 and sVCAM-1 in patients with gastric cancer.METHODS The serum levels of soluble ICAM-1 and VCAM-1 were measured with sandwith enzyme immunoassay.RESULTS In gastric cancer patients, soluble ICAM-1 and VCAM-1 concentrations were significantly elevated in comparision with those of healthy subjects (289.23μg/L±32.69μg/L vs 190.44μ/L±35.92μg/L,1430.88μg/L±421.71μg/L vs 727.24μg/L±157.68μg/L, respectively, P＜0.01). The increment in serum sICAM-1 and sVCAM-1 concentrations correlated well with the staging of gastric cancer. The serum levels of sICAM-1 and sVCAM-1 in patients of Ⅲ-Ⅳ stages were higher than those of Ⅰ-Ⅱ stages (346.60μg/L±92.10μg/L vs 257.54μg/L±32.77μg/L, 1800.60μg/L±510.76μg/L vs 1262.81μg/L±236.73μg/L). The levels of sICAM-1 and sVCAM-1 were correlated significantly (r=0.49,P＜0.01). The sICAM-1 and sVCAM-1 levels correlated positively with alkaline phophatase (r=0.63,0.71,P＜0.001) and white cell count (r=0.52,0.43, P＜0.01); but correlated negatively with serum albumin (r=-0.41, -0.49, P＜0.01).CONCLUSION The measurement of circulating ICAM-1 and VCAM-1 may bring additional prognostic information for patients with gastric cancer in varying stages.INTRODUCTIONTumor growth and metastasis involves a variety of cell-cell and cell-extracellular matrix interactions mediated by cell adhesion molecules. Currently, a number of cell adhesion molecules, such as intercellular adhesion molecules-1 (ICAM-1), vascular cell adhesion molecules-1 (VCAM-1), etc. have been found.ICAM-1 and VCAM-1 are members of the immunoglobulin supergene family which are cytokine-induced glycoproteins (IL-1, TNFα and IFNγ). Both of them have five or seven extracellular immunoglobulin-like domains, a single transmembranous domain and a short cytoplasmic tail[1,2]. The natural ligand of ICAM-1 or VCAM-1 is LFA-1 (CD11a) and Mac-1 (CD11b) or VLA-4, respectively[3]. ICAM-1 is a widely distributed protein on a variety of tissues, and can be detected in many cells such as macrophage, T- and B-cells, or fibroblasts, endothelial and epithelial cells. VCAM-1 is also a widely distributed protein and is constitutively expressed on tissue macrophage, dentritic cells in lymphoid tissue and skin, as well as on bone marrow fibroblasts and epithelial cells. Expression of VCAM-1 is inducible on vascular endothelial cells under pathological conditions[4].Recently, soluble forms of several adhesion molecules including ICAM-1 and VCAM-1 were found in serum of normal donors[5]. Abnormally high levels of them have been described in some solid malignant tumors, leukemia, autoimmune disease, infectious disease, etc.The present study was carried out to measure the circulating levels of sICAM-1 and sVCAM-1 in gastric cancer before treatment was given and to study their correlation with clinical, histological and routine laboratory parameters.     

Soluble intercelluar adhesion molecule-1, E-selectin, vascular cell adhesion molecule-1 and von Willebrand factor in stroke.

We investigated the role of endothelial cell and leukocyte adhesion in the pathophysiology of acute stroke. The immunocytochemical expression of adhesion molecules in brain tissue from six patients who died following acute ischaemic stroke showed weak endothelial expression of intercellular adhesion molecule-1 (ICAM-1), but intense expression of vascular cell adhesion molecule-1 (VCAM-1) by astrocytes and endothelial cells from the infarcted, but not the non-infarcted areas. We also measured soluble adhesion molecules E-selectin, ICAM-1, VCAM-1 and von Willebrand factor (all by enzyme-linked immunosorbent assay) in 21 patients after an acute ischaemic stroke (ictus < 12 h), and again 3 months later. Blood levels in the stroke patients were compared with 82 healthy controls and 22 subjects with carotid atherosclerosis. Compared with healthy controls, both patient groups had raised levels of von Willebrand factor (P < 0.02) but the level of soluble VCAM-1 was raised only in patients with acute stroke (P < 0.02). Levels of von Willebrand factor and soluble VCAM-1 in the stroke patients were still high at 3 months follow-up. We suggest that there might be changes in adhesion molecule expression and release in the acute and chronic stages of ischaemic stroke, where blood levels are related to immunocytochemical findings on infarcted brain. These changes may perhaps be part of the complex pathophysiological responses to infarction and repair of brain tissue following stroke.     

糖尿病患者血清可溶性细胞间粘附分子-1和可溶性血管细胞粘附分子-1变化的研究

目的　研究糖尿病患者血清可溶性细胞间粘附分子 - 1(s ICAM- 1)和可溶性血管细胞粘附分子 - 1(s VCAM- 1)水平的变化。方法　应用酶联免疫吸附法 (EL ISA)检测了 18例 1型糖尿病和 47例 2型糖尿病患者及 2 0例健康对照者的血清 s ICAM- 1、s VCAM- 1以及甘油三酯 (TG)水平。结果　 1血清 s ICAM- 1和 s VCAM- 1水平 ,1型、2型糖尿病患者组均显著高于健康对照组 (P<0 .0 5～ 0 .0 1) ,2型糖尿病有微血管病变组又高于无微血管病变组 (P<0 .0 5～ 0 .0 1) ,1型糖尿病与 2型糖尿病组之间无显著性差异 ;2血清 s VCAM- 1水平 ,2型糖尿病的高甘油三酯血症组 (A组 )、高甘油三酯血症合并高血压组 (B组 )高于单纯高血压组 (C组 )和甘油三酯、血压正常组 (D组 ) (P均 <0 .0 5 ) ;3 1型糖尿病和 2型糖尿病患者血清 s ICAM- 1和 s VCAM- 1之间均呈正相关关系 (r=0 .83、0 .5 3,P均 <0 .0 1)。结论　 12型糖尿病患者血清 s VCAM- 1升高与高甘油三酯血症有关 ;2血清 s ICAM- 1和 s VCAM- 1参与了糖尿病微血管病变的发病过程 ,并可作为糖尿病病情变化的监测指标     

Circulating intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and E-selectin in patients with type 2 diabetes mellitus

Serum levels of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin in patients with type 2 diabetes mellitus (n = 64) and control subjects (n = 40) were studied. Serum ICAM-1 concentrations in diabetic patients were significantly higher than those of control subjects (378.2 +/- 70.0 versus 220.4 +/- 31.8 ng/ml, P < 0.01). By multiple regression analysis, hemoglobin A1c was independently associated with serum ICAM-1 concentration in patients with diabetes. The serum VCAM-1 concentration of diabetic patients with macroangiopathy was higher than those of patients without macroangiopathy and of control subjects (806.9 + 276.5 versus 639.0 +/- 146.0 (P < 0.01), and 652.1 +/- 146.9 ng/ml (P < 0.01), respectively). There was no difference in serum E-selectin concentration between diabetic patients with or without macroangiopathy and normal control subjects. These results suggest that adhesion molecules may contribute to the development of atherosclerosis in the diabetic state.     

血清SICAM-1、SVCAM-1表达与代谢综合征及其组分的关系

目的探讨血清可溶性细胞间黏附分子1（SICAM-1）和可溶性血管细胞黏附分子1（SVCAM-1）水平与代谢综合征（MS）及其组分的关系。方法将108名体检者按是否具有MS及其组分分组，并按具有MS组分的个数分组，采用酶联免疫吸附法检测血清SICAM-1和SVCAM-1水平，并与糖脂代谢指标及HOMA-IR作相关性分析。结果具有MS及其组分者SICAM-1、SVCAM-1水平分别较无MS及其组分者明显升高，而且随着MS组分数目增加，SICAM-1、SVCAM-1水平亦明显升高。结论SICAM-1、SVCAM-1均与糖脂代谢指标及HOMA—IR相关。MS组分的累积加重了血管内皮功能障碍，血管内皮功能障碍可能参与了MS的发生与发展。     

Plasma soluble adhesion molecules; intercellular adhesion molecule-1, vascular cell adhesion molecule-1 and E-selectin levels in patients with isolated coronary artery ectasia

Plasma soluble adhesion molecules, intercellular adhesion molecule-1 (ICAM)-1, vascular cell adhesion molecule-1 (VCAM-1) and E-selectin leves of patients with isolated coronary artery ectasia (CAE), patients with obstructive coronary artery disease without CAE and subjects with angiographically normal coronary arteries were evaluated. Patients with isolated CAE were detected to have significantly higher levels of plasma soluble ICAM-1, VCAM-1 and E-selectin in comparison with patients with obstructive coronary artery disease without CAE (ICAM, 673 +/- 153 versus 381 +/- 106, respectively, P < 0.001; VCAM-1, 2366 +/- 925 versus 1136 +/- 208, respectively, P < 0.001; E-selectin, 74 +/- 21 versus 61 +/- 18, respectively, P = 0.01) and subjects with normal coronary arteries (ICAM-1, 673 +/- 153 versus 303 +/- 131, respectively, P < 0.001; VCAM-1, 2366 +/- 925 versus 729 +/- 231, respectively, P < 0.001; E-selectin, 74 +/- 21 versus 49 +/- 9, respectively, P < 0.001), suggesting the presence of a more severe and extensive chronic inflammation in the coronary circulation in patients with isolated CAE. BACKGROUND: The common coexistence of coronary artery ectasia (CAE) with coronary artery disease (CAD) suggests that it may be a variant of CAD. However, it is not clear why some patients with obstructive CAD develop CAE whereas most do not. Inflammation has been reported to be a major contributing factor to both obstructive and aneurysmatic vascular disorders and therefore, in the present study, the plasma soluble adhesion molecules, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin levels in isolated CAE were investigated. METHODS: The study population consisted of three groups: the first consisted of 32 patients with isolated CAE without stenotic lesion; the second of 32 patients with obstructive CAD without CAE; and the third group of 30 control subjects with normal coronary arteries. Coronary diameters were measured as the maximum diameter of the ectasic segment by use of a computerized quantitative coronary angiography analysis system. According to the angiographic definition used in the Coronary Artery Surgery Study, a vessel is considered to be ectasic when its diameter is > or =1.5 times that of the adjacent normal segment in segmental ectasia. Plasma soluble ICAM-1, VCAM-1 and E-selectin levels were measured in all patients and control subjects using commercially available enzyme-linked immunosorbent assay kits. RESULTS: Patients with isolated CAE were found to have significantly higher levels of plasma soluble ICAM-1, VCAM-1, and E-selectin in comparison with patients with obstructive CAD without CAE (ICAM, 673 +/- 153 versus 381 +/- 106, respectively; P < 0.001; VCAM-1, 2366 +/- 925 versus 1136 +/- 208, respectively; P < 0.001; E-selectin, 74 +/- 21 versus 61+/-18, respectively; P = 0.01) and control subjects with normal coronary arteries (ICAM-1, 673 +/- 153 versus 303 +/- 131, respectively;, P < 0.001; VCAM-1, 2366 +/- 925 versus 729 +/- 231, respectively; P < 0.001; E-selectin, 74 +/- 21 versus 49 +/- 9, respectively; P < 0.001). In addition, we detected statistically significant positive correlation between the total length of ectasic segments and the levels of plasma soluble ICAM-1 (r = 0.625; P < 0.001), VCAM-1 (r = 0.548; P = 0.001) and E-selectin (r = 0.390; P = 0.027). Multivariate logistic regression analysis revealed a significant independent relation between isolated CAE and ICAM-1 [odds ratio (OR) = 1.023; 95% confidence interval (CI) = 1.0048-1.0414; P = 0.0129] and VCAM-1 (OR = 1.0057; 95% CI = 1.0007-1.0106; P = 0.0240). CONCLUSIONS: We have shown that patients with isolated CAE have raised levels of plasma soluble ICAM-1, VCAM-1 and E-selectin in comparison with patients with obstructive CAD without CAE and control subjects with normal coronary arteries, suggesting the presence of a more severe and extensive chronic inflammation in the coronary circulation in these patients.