细胞间粘附分子1、血管细胞粘附分子1和肿瘤坏死因子α在人动脉粥样硬化病灶中的表达及意义

为研究细胞间粘附分子 1、血管细胞粘附分子 1和肿瘤坏死因子α在人正常冠状动脉与冠状动脉粥样硬化组织中的表达及病理学意义 ,采用免疫组织化学SP法 ,分别检测细胞间粘附分子 1、血管细胞粘附分子 1和肿瘤坏死因子α在人正常冠状动脉与冠状动脉粥样硬化组织中的表达情况。结果发现 ,细胞间粘附分子 1、血管细胞粘附分子 1和肿瘤坏死因子α在动脉粥样硬化组织中的内皮细胞、平滑肌细胞、巨噬细胞均有表达。三者在脂纹期的表达分别为 5 0 .0± 10 .9、5 1.8± 6 .0和 13.9± 2 .8,在纤维斑块期分别为 2 3.1± 7.3、37.2± 9.7和 2 3.0± 6 .0 ,在粥样斑块期分别为 17.5± 4 .9、18.6± 5 .5和 38.0± 10 .0 ,明显高于对照组 (2 .2± 1.4、2 .2± 1.2和 7.8± 2 .2 ,分别为P<0 .0 1)。细胞间粘附分子 1和血管细胞粘附分子 1与肿瘤坏死因子α呈正相关 (前者r=0 .344、P <0 .0 1,后者r=0 .5 2、P <0 .0 1)。实验结果提示 ,细胞间粘附分子 1和血管细胞粘附分子 1在内皮细胞、平滑肌细胞和巨噬细胞高表达可能参与动脉粥样硬化发生发展过程中的某些环节。肿瘤坏死因子α的表达与细胞间粘附分子 1和血管细胞粘附分子 1的表达及动脉粥样硬化病变程度具有相关性。     

血浆可溶性细胞间粘附分子—1：不稳定型心绞痛时炎症反应的指标

越来越多证据表明炎症在不稳定型心绞痛的发生发展中起着非常重要的作用 ,细胞间粘附分子 1是白细胞整合素CD18家族的主要配体 ,介导着白细胞与激活的内皮细胞间粘附 ,从而介导炎症反应。本文检测 15例不稳定型心绞痛 (UA) ,16例稳定劳力型心绞痛 (SEA)及 15例健康者血浆可溶性细胞间粘附分子 1(sICAM 1)的浓度。UA组血浆sICAM 1水平 (ng/ml)比SEA组以及健康对照组明显升高 (181± 12vs 139± 7,131± 9,P <0 .0 5 )。结果表明UA患者循环中sICAM 1水平升高支持炎症反应在UA中的病理作用。检测sICAM 1可作为炎症引起的UA的有用指标。     

2型糖尿病肾病患者血清细胞粘附分子变化与氧化应激的关系

目的　探讨 2型糖尿病肾病患者 (DN)血清细胞粘附分子变化及其与氧化应激的关系。　方法　检测DN患者血清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)、血清丙二醛 (MDA)含量和超氧化物歧化酶 (SOD)活性。　结果　早期DN及DN患者血清sVCAM 1水平〔分别为 (1 75± 0 48)、(1 91± 0 2 7)mg/L〕明显高于对照组〔(1 6 7± 0 72 )mg/L ,P <0 0 5和0 0 1〕 ,DN组明显高于单纯糖尿病 (DM)组〔(1 5 8± 0 39)mg/L ,P <0 0 5〕 ;DM组、早期DN组和DN组患者血清sICAM 1〔分别为 (75 6 0 0± 12 5 47)、(80 2 2 1± 12 4 81)、(897 6 0± 10 5 80 ) μg/L〕明显高于对照组〔(5 82 6 4± 10 2 73) μg/L ,P <0 0 0 1〕 ,其中DN组明显高于单纯DM组和早期DN组 (分别P <0 0 1和<0 0 5 ) ;单纯DM组、早期DN组和DN组患者血清SOD活性〔分别为 (86 5 9± 13 85 )、(85 6 9±11 32 )、(71 73± 16 35 )NU/L〕显著性低于对照组〔(92 73± 11 2 5 )NU/ml,P <0 0 1〕 ,MDA含量〔分别为(3 99± 1 36 )、(4 2 6± 1 95 )、(6 5 0± 2 98)nmol/ml〕显著性高于对照组〔(3 72± 0 5 7)nmol/ml,P <0 0 1〕。DM患者血清sVCAM 1与sICAM 1、收缩压、尿素氮 (BUN)和肌酐 (Cr)呈正相     

低密度脂蛋白不同亚组分对血管内皮细胞粘附分子表达的不同影响

通过观察低密度脂蛋白不同亚组分对细胞间粘附分子 1和血管细胞粘附分子 1表达的影响 ,来探讨低密度脂蛋白致动脉粥样硬化的分子机制。采用两次超速离心法分离制备大颗粒疏松低密度脂蛋白和小颗粒致密低密度脂蛋白 ,在内皮细胞培养基中分别加入不同剂量的天然或氧化型小颗粒致密或大颗粒疏松这 4种脂蛋白 ,37℃温育 12h ,用细胞酶联免疫吸附法检测细胞间粘附分子 1和血管细胞粘附分子 1蛋白的表达。结果发现 ,不同剂量的 4种脂蛋白均可使细胞间粘附分子 1和血管细胞粘附分子 1蛋白表达增高 ,天然或氧化型小颗粒致密低密度脂蛋白增加内皮细胞表面细胞间粘附分子 1和血管细胞粘附分子 1蛋白表达呈剂量依赖性。比较相同浓度的 4种脂蛋白的作用时发现 ,2 5mg和 5 0mg小颗粒致密低密度脂蛋白增加细胞间粘附分子 1和血管细胞粘附分子 1表达的作用强于大颗粒疏松低密度脂蛋白 ,但差异无统计学意义 ;10 0mg天然小颗粒致密低密度脂蛋白增加细胞间粘附分子 1和血管细胞粘附分子 1表达的作用强于其它三种脂蛋白 (细胞间粘附分子 1的表达分别为 0 .83± 0 .0 9、0 .6 6± 0 .15、0 .80± 0 .0 7和 0 .76± 0 .0 8;血管细胞粘附分子 1的表达分别为 0 .37± 0 .0 4、0 .2 8± 0 .0 4、0 .2 9± 0 .0 2和0 .2 7± 0 .0     

氟伐他汀对高脂血症患者的血脂及细胞粘附分子的影响

为研究氟伐他汀对高脂血症患者的降脂作用及对细胞粘附分子的影响。选择高脂血症患者 5 8例 (男性 35例 ,女性 2 3例 ) ,予氟伐他汀 4 0mg口服 ,每晚一次 ,一周后改为 2 0mg ,每晚一次 ,疗程 6～ 8周。分别观测治疗前后血脂及细胞粘附分子的情况。结果发现 ,治疗后患者总胆固醇、甘油三酯、低密度脂蛋白、血清可溶性细胞间粘附分子 1和血清可溶性血管细胞粘附分子 1明显降低 (P <0 .0 5 ) ,而高密度脂蛋白升高不明显。此结果提示 ,氟伐他汀不但能降低总胆固醇、甘油三酯及低密度脂蛋白水平 ,而且能降低血清可溶性细胞间粘附分子 1和血清可溶性血管细胞粘附分子 1浓度。     

格列美脲降低2型糖尿病患者血清E-选择素和血管细胞粘附分子1水平

了解 2型糖尿病患者血清可溶性粘附分子的水平 ,以及格列美脲降糖治疗后其变化情况。采用酶联免疫吸附法测定 2型糖尿病患者格列美脲治疗前后与对照组血清E 选择素、细胞间粘附分子 1和血管细胞粘附分子1的浓度。结果显示 2型糖尿病患者治疗前血清E 选择素、细胞间粘附分子 1和血管细胞粘附分子 1的水平明显高于对照组 (P <0 .0 0 1)。格列美脲治疗 8周后患者血清E 选择素和血管细胞粘附分子 1的水平均降低 (P <0 .0 5 ) ,但细胞间粘附分子 1与治疗前比较无变化。格列美脲降糖治疗可能有助于改善糖尿病状态下的内皮细胞损伤和激活     

急性冠状动脉综合征患者血清可溶性细胞间粘附分子1和妊娠相关血浆蛋白A的变化

目的 观察急性冠状动脉综合征患者血清可溶性细胞问粘附分子1、妊娠相关血浆蛋白A水平的变化，结合冠状动脉造影结果探讨其临床意义。方法 用酶联免疫吸附法检测46例急性冠状动脉综合征患者（其中急性心肌梗死20例，不稳定型心绞痛26例）、22例稳定型心绞痛患者和20例冠状动脉造影阴性对照者血清可溶性细胞问粘附分子1、妊娠相关血浆蛋白A水平，分析冠状动脉病变程度与可溶性细胞间粘附分子1、妊娠相关血浆蛋白A浓度的关系。结果急性冠状动脉综合征组血清可溶性细胞间粘附分子1和妊娠相关血浆蛋白A浓度较稳定型心绞痛组、对照组显著升高（P〈0．05或P〈0．01）。冠状动脉造影为单支、双支、三支病变者，其可溶性细胞问粘附分子1、妊娠相关血浆蛋白A浓度依次增高。相关分析发现，急性心肌梗死、不稳定型心绞痛患者血清可溶性细胞间粘附分子1浓度与妊娠相关血浆蛋白A浓度显著正相关（r=0．737和r=0．758，P〈0．001）。结论 急性冠状动脉综合征患者可溶性细胞阃粘附分子1、妊娠相关血浆蛋白A升高，二者可能是动脉粥样斑块不稳定的标志。     

急性冠状动脉综合征患者冠状动脉循环粘附分子的变化

目的探讨急性冠状动脉综合征患者冠状动脉循环血浆细胞间粘附分子1和血管细胞粘附分子1水平变化的临床意义.方法应用酶联免疫吸附法检测65例冠心病患者(30例急性冠状动脉综合征,35例稳定型心绞痛)及27例对照者冠状动脉循环(冠状静脉窦-主动脉根部)血浆细胞间粘附分子1和血管细胞粘附分子1水平,比较其水平变化与不同冠心病类型之间的关系.结果急性冠状动脉综合征组冠状静脉窦和主动脉根部血浆细胞间粘附分子l和血管细胞粘附分子1水平明显高于稳定型心绞痛组和对照组(P＜0.05);急性冠状动脉综合征组冠状动脉循环(冠状静脉窦与主动脉根部的差值)血浆细胞间粘附分子1和血管细胞粘附分子1水平明显高于稳定型心绞痛组和对照组(P＜0.01).稳定型心绞痛组和对照组冠状静脉窦、主动脉根部和冠状动脉循环血浆细胞间粘附分子1和血管细胞粘附分子1水平无明显差别(P＞0.05).血浆细胞间粘附分子1和血管细胞粘附分子1水平与冠状动脉病变受累支数无关.结论急性冠状动脉综合征时血浆细胞间粘附分子1和血管细胞粘附分子1浓度显著升高,冠状动脉循环血浆细胞间粘附分子1和血管细胞粘附分子1变化反映冠状动脉炎症活动程度,细胞粘附分子参与斑块的不稳定.     

冠心病患者血清C反应蛋白和可溶性细胞间粘附分子1与肺炎衣原体感染的相关性

目的探讨冠心病患者血清炎症标志物C反应蛋白和可溶性细胞间粘附分子1水平的变化及其与肺炎衣原体感染的关系。方法采用酶联免疫吸附法检测60例急性心肌梗死、不稳定型心绞痛、陈旧性心肌梗死、稳定型心绞痛及40例对照者血清C反应蛋白、可溶性细胞间粘附分子1及肺炎衣原体抗体IgG、IgM。结果冠心病组肺炎衣原体IgG阳性率和浓度均高于对照组(P<0.01),冠心病各组之间肺炎衣原体IgG和IgM阳性率差异无显著性(P>0.05),急性心肌梗死组肺炎衣原体IgG浓度高于陈旧性心肌梗死组、不稳定型心绞痛组和稳定型心绞痛组(P<0.05);冠心病组C反应蛋白、可溶性细胞间粘附分子1水平高于对照组(P<0.01),急性心肌梗死组C反应蛋白、可溶性细胞间粘附分子1水平高于不稳定型心绞痛组、陈旧性心肌梗死组和稳定型心绞痛组(P<0.01),不稳定型心绞痛组C反应蛋白、可溶性细胞间粘附分子1水平高于稳定型心绞痛组(P<0.05);肺炎衣原体IgG浓度、C反应蛋白、可溶性细胞间粘附分子1之间有很好的相关性(P<0.05)。结论炎症标志物水平变化在一定程度上反映了冠心病患者病情变化,肺炎衣原体感染与冠心病有关,炎症、感染可能共同参与了冠心病的发生发展。     

2型糖尿病患者血清血管细胞粘附分子1水平变化及其机制

血管细胞粘附分子 1(VCAM 1)属粘附分子免疫球蛋白超家族 ,主要表达于活化的血管内皮细胞表面 ,介导淋巴细胞、单核细胞和内皮细胞的粘附 ,参与许多重要的病理生理过程。sVCAM 1是VCAM 1的可溶性形式。本研究测定 2型糖尿病患者血清sVCAM 1水平变化并对可能的机制进行探讨。　　一、对象与方法1 对象 :2型糖尿病患者 6 0例 (WHO1985年标准 ) ,男 2 4例 ,女 36例 ;6 0例中有微血管病变者 2 6例 ,无微血管病变者34例。病程 6个月 15年 ;年龄 ( 5 7± 7)岁 ( 4 2～ 6 8岁 ) ,空腹血糖 ( 8 6± 1.7)mmol/L( 7.3～ 10 .8mmol/L) ,糖化血…     

Influence of hepatitis C virus infection on soluble cellular adhesion molecules in hemodialysis patients

BACKGROUND/AIMS: Higher levels of soluble cellular adhesion molecules have been found to be a strong indicator of endothelial dysfunction and atherosclerosis in the general population. In hemodialysis patients, soluble cellular adhesion molecules have been found at higher levels as well. Such an increase has been considered as a sign of chronic inflammation. Chronic viral hepatitis C (HCV) infection, highly prevalent in hemodialysis patients, is also a disease that can induce chronic inflammation. We conducted a cross-sectional association study of soluble cellular adhesion molecules and hepatitis C in maintenance hemodialysis patients. METHODS: A total of 87 stable hemodialysis patients were included in this study, mean age was 60.0 +/- 13.7 years. Anti-HCV antibody and HCV RNA assay were done. Patients were divided into anti-HCV-positive and anti-HCV-negative groups. Predialytic serum soluble intercellular adhesion molecules-1 (sICAM-1), soluble vascular cellular adhesion molecules-1 (sVCAM-1), and soluble E-selectin were assayed by commercially available enzyme-linked immunosorbent assay (ELISA) kits. The results were correlated with other hematological and biochemical results. RESULTS: In the anti-HCV-positive group, the time on hemodialysis was longer (105.5 +/- 65.7 vs. 49.2 +/- 44.0 months, p = 0.001). The sICAM-1, sVCAM-1 and E-selectin levels were higher in the anti-HCV-positive group. HCV infection was determined as an independent determinant of sICAM-1 and sVCAM-1 by multiple linear regression analysis. CONCLUSION: Elevated serum soluble cellular adhesion molecules are multifactorial in hemodialysis patients. The role of HCV infection must be considered. The clinical significance and implications of soluble cellular adhesion molecules remains to be elucidated.     

氟伐他汀对充血性心力衰竭患者血清sICAM-1和sVCAM-1的影响

目的:探讨氟伐他汀短期治疗对充血性心力衰竭(CHF)患者血清中可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)和肿瘤坏死因子α(TNF-α)水平的影响。方法:将97例CHF患者随机分为对照组(常规治疗组)和试药组(氟伐他汀组)。采用ELISA测定治疗前及治疗两周后血清中sICAM-1、sVCAM-1和TNF-α水平。结果:两种方法都可以明显降低血清sICAM-1、sVCAM-1和TNF-α水平(P0.05);试药组血清TNF-α水平降低更为显著(P0.05),但血清sICAM-1和sVCAM-1降低水平与对照组无显著差别。结论:在常规治疗基础上短期加用氟伐他汀治疗不能进一步降低CHF患者血清sICAM-1和sVCAM-1水平。     

Elevated levels of circulating adhesion molecules in patients with active pulmonary tuberculosis

OBJECTIVE: Recent studies have indicated the importance of cell adhesion molecules in the pathogenesis of various inflammatory lung diseases. Our study was designed to determine whether five soluble adhesion molecules including soluble L-, E- and P-selectin (sL-, sE- and sP-selectin), intercellular adhesion molecule-1 (sICAM-1), and vascular cell adhesion molecule-1 (sVCAM-1) in serum reflect the severity of active pulmonary tuberculosis (TB), and whether there is a distinct profile of these soluble molecules in this disease. METHODOLOGY: Using enzyme-linked immunosorbent assays, we measured the serum levels of these five soluble adhesion molecules in 31 patients with active TB and 11 healthy volunteers. RESULTS: Serum levels of sE-selectin, sP-selectin and sICAM-1, but not sL-selectin or sVCAM-1, were significantly higher in patients with active TB than in the control subjects (P < 0.001, each). Significant correlations were detected only between serum levels of sE-selectin and sP-selectin, sE-selectin and sICAM-1, and sP-selectin and sICAM-1. There was a significant correlation between the Gaffky scale result (a scale assessing the number of mycobacteria bacilli present) and all of the above adhesion molecules, except for sL-selectin. Serum levels of sE-selectin, sL-selectin and sICAM-1 also correlated with the CXR radiological score. Higher levels of sL-selectin and sICAM-1 were detected in the serum of patients with radiological cavity formation compared to those without. The ESR, C-reactive protein and circulating neutrophil counts all correlated significantly with sE-selectin, sP-selectin, sICAM-1 and sVCAM-1. CONCLUSION: The results suggest that there is a distinct profile of soluble adhesion molecules in active pulmonary TB and that sE-selectin, sP-selectin, and especially sICAM-1 appear to be the most sensitive clinical measures of disease severity.     

有氧运动对急性冠脉综合征患者血清黏附分子和C反应蛋白的影响

目的: 探讨有氧运动对急性冠脉综合征(ACS)患者可溶性细胞间黏附分子-1(sICAM-1)、血管细胞黏附分子-1(sVCAM-1)和C反应蛋白(CRP)水平的影响。方法: 选取ACS患者70例,将其分为常规治疗组和有氧运动+常规治疗组（加有氧运动组）。另选健康成人为正常对照组。采用酶联免疫吸附法测定各组sICAM-1和sVCAM-1 水平,采用免疫浊度法测定CRP浓度。结果: ACS 患者循环血中sICAM-1、sVCAM-1和CRP水平明显高于正常对照组(P<0.01),两组治疗1个月后sICAM-1、sVCAM-1和CRP水平均较治疗前均明显下降(P<0.05和P<0.01)。且两组各项指标比较,加有氧运动组降低更显著(P<0.05)。结论: ACS 患者血清中sICAM-1、sVCAM-1和CRP水平明显升高,而有氧运动能明显降低ACS患者血中sICAM-1、sVCAM-1和CRP水平。     

Soluble intracellular adhesion molecules (sICAM-1, sVCAM-1) in peripheral blood of patients with thyroid cancer

The growth of a neoplasm and its ability to form metastases is a multistep process dependent on angiogenesis and immunological reactions of the organism. In this process adhesive factors are also involved. The aim of this work was estimation of the concentration of soluble intercellular adhesion molecules (sICAM-1) and vascular cellular adhesion molecules (sVCAM-1) in the serum of peripheral blood of patients with thyroid cancer before operation. The study comprised 48 patients ( 38 women and 10 men) aged from 18 to 87 years, in whom thin needle aspiration biopsy revealed cancer of the thyroid. Postoperative histopathological examination showed papillary cancer in 35 patients, oxyphilic cancer in 5 patients, anaplastic cancer in 4 and medullary cancer in 4 patients. In those patients, using the immunoenzymatic method ELISA, the concentration of sICAM-1 and sVCAM-1 in the serum of peripheral blood was determined. The control group comprised 26 healthy persons. We found statistically significant increase of sICAM-1 concentration in serum in all forms of cancer, in comparison with the control group. Mean concentrations of sICAM-1 were as follows: in papillary cancer patients 455.23+/-28.66 vs. 299.62+/-11.54 ng/ml, p<0.05; in oxyphilic cancer 455.60+/-95.21 vs. 299.62+/-11.54 ng/ml, p<0.05; in anaplastic cancer 570.00+/-170.89 vs. 299.62+/-11.54 ng/ml, p<0.05; and in medullary cancer 512.00+/-11.46 vs. 299.62+/-11.54 ng/ml, p<0.05. The mean concentration of sVCAM-1 in serum was statistically significantly higher than in the control group only in case of anaplastic cancer (1033.75+/-86.30 vs. 644.58+/-27.30 ng/ml; p<0.05). We evaluated the correlation coefficient between the concentration of sICAM-1 and sVCAM-1 in the serum of patients with thyroid cancer. Positive correlation was observed between the concentration of sICAM-1 and sVCAM-1. The obtained results confirm essential role of the investigated adhesive factors in the process of thyroid cancer growth.     

Circulating soluble vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 in immunocompetent and renal transplant patients: correlation with cytomegalovirus disease and renal function.

The plasma levels of the soluble adhesion molecules, soluble vascular cell adhesion molecule-1 (sVCAM-1) and intercellular adhesion molecule-1 (sICAM-1), were measured before and after transplantation in 26 renal transplant recipients, and in 173 longitudinally collected samples in 17 of the patients. The patients were carefully monitored for the presence of cytomegalovirus (CMV) infection and rejection. Forty healthy blood donors and 12 otherwise healthy subjects with symptomatic primary CMV infections served as controls. During CMV disease, plasma levels of sVCAM-1 and sICAM-1 were elevated in both renal transplant patients and otherwise healthy subjects with CMV disease. The sVCAM-1 levels were strongly elevated before transplantation in renal transplant recipients and correlated with creatinine levels. Increased sVCAM-1 levels were also registered during rejection episodes. CMV disease, per se, is associated with markedly increased levels of sVCAM-1 and sICAM-1. There is also a correlation of sVCAM-1 levels with serum creatinine levels. Thus, the presence of CMV infection and renal function are factors that must be considered in further studies of soluble adhesion molecules.     

Soluble adhesion molecules (ICAM-1, VCAM-1, and E-selectin) and vascular endothelial growth factor (VEGF) in patients with distinct variants of rheumatoid synovitis

BACKGROUND: Cell adhesion molecules and endothelial growth factors have an important role in the infiltrating of rheumatoid synovium with mononuclear cells, leading to the initiation and progression of the disease. OBJECTIVE: To investigate whether the serum profile of soluble adhesion molecules and of vascular endothelial growth factor (VEGF) is associated with the histological appearance of rheumatoid arthritis (RA). METHODS: Serum levels of soluble intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), E-selectin (sE-selectin), and VEGF were assessed by enzyme linked immunosorbent assay (ELISA) in 40 patients with RA and 32 patients with osteoarthritis (OA). RESULTS: Histological analysis of synovium specimens distinguished two types of rheumatoid synovitis. Twenty four RA samples presented diffuse infiltrates of mononuclear cells without any further microanatomical organisation, whereas in the remaining 16 samples lymphocytic follicles with germinal centre-like structures were identified. In comparison with patients with OA, constituting a control group, higher serum concentrations of sICAM-1 (p<0.001), sVCAM-1 (p<0.001), sE-selectin (p<0.01), and VEGF (p<0.001) were detected in patients with RA. Raised concentrations of sICAM-1, sVCAM-1, and VEGF dominated in the serum of patients with RA with follicular synovitis compared with those with diffuse synovitis (p<0.01 for all comparisons). The serum concentrations of sICAM-1, sVCAM-1, and VEGF correlated with markers of disease activity such as the erythrocyte sedimentation rate and C reactive protein levels. Furthermore, the clinical data analysed in our study indicated that patients with RA with follicular synovitis tend to have more severe disease. CONCLUSIONS: The distinct histological appearances of rheumatoid synovitis associated with different serum profiles of sICAM-1, sVCAM-1, and VEGF reflect varied clinical activity of the disease and confirm RA heterogeneity. Patients with different histological forms of synovitis may respond differently to the treatment regimens.     

早期调脂干预对急性心肌梗死患者炎症因子的影响

目的观察早期较大剂量阿托伐他汀治疗急性心肌梗死(AMI)3d后患者血清可溶性CD40L(sCD40L)、P-选择素及可溶性血管粘附分子水平的变化,以探讨早期调脂干预对AMI斑块稳定、抑制炎症反应的作用。方法选取43例AMI患者随机分为常规治疗组(无服用任何调脂药物,21例)和阿托伐他汀组(立普妥20mg,qd,22例),测定治疗前后sCD40L、P-选择素、可溶性细胞间粘附分子-1(sICAM-1)和可溶性血管细胞间粘附分子-1(sV-CAM-1)的水平。结果两组治疗前后血脂水平变化无显著性差异。阿托伐他汀组治疗后血清sCD40L、P-选择素、sICAM-1分别下降35％、41％、30％,明显低于治疗前水平(P<0.05),sVCAM-1稍下降,但无统计学意义;在常规治疗组治疗前后上述指标均无明显变化。在阿托伐他汀组sCD40L、P-选择素、sICAM-1的降低与总胆固醇(TC)(分别为r=0.08,P=0.56;r=0.16,P=0.34;r=0.12,P=0.41),低密度脂蛋白胆固醇(LDL-C)(分别为r=0.09,P=0.88;r=0.11,P=0.46;r=0.18,P=0.77)的下降百分数之间无相关关系。结论在AMI的早期使用阿托伐他汀治疗3d,可明显降低血清炎症因子水平,可能有利于动脉粥样硬化斑块的稳定。     

Soluble adhesion molecules and cytokines in patients with myasthenia gravis treated by plasma exchange

Plasma exchange (PE) is an effective therapeutic method used in patients with myasthenia gravis (MG) refractory to common therapy and/or with life-threatening respiratory complications. Except for acetylcholine receptor antibodies (AChRAbs), some other inflammatory mediators possibly activated in MG may also be removed during PE. Serum levels of soluble adhesion molecules (sICAM-1 and sVCAM-1), IL-6 and soluble receptors for IL-2 (sIL-2R), IL-6 (sIL-6R) and TNF alpha (sTNF-R II) were measured in 20 MG patients assigned to treatment with PE. On the basis of the serum levels of AChRAb the patients were subdivided into 2 groups (8 patients with low AChRAb, 12 patients with high AChRAb). Soluble adhesion molecules and cytokines were measured before the first and last PE, at the end of the first PE and in the samples of plasma filtrate obtained during the first PE. Before the first PE patients with MG had higher serum levels of sICAM-1, sVCAM-1, sIL-2R and sTNF-R II than controls. Both after the first PE and during the course of PE, a substantial decrease in serum levels of AChRAb, sICAM-1 and sVCAM-1 was recorded. However, serum levels of sIL-2R and sTNF-R II were not significantly influenced by either a single treatment or during the course of PE. There were high levels of AChRAb, soluble adhesion molecules and soluble cytokine receptors in plasma filtrates too. Patients with high circulating AChRAb had higher serum levels of sICAM-1 and sVCAM-1 than patients with low AChRAb. Increased serum levels of soluble adhesion molecules and soluble cytokine receptors in patients with MG suggest some systemic activation of the immune response which is more pronounced in patients with high circulating AChRAb. PE led to the decrease in serum AChRAb and soluble adhesion molecules due to their effective filtration but, on the other hand, serum levels of soluble cytokine receptors were not influenced by PE, in spite of their effective filtration which is probably counteracted by their increased production, possibly stimulated by the contact of the blood with the synthetic membrane.     

Circulating adhesion molecules in sera of asthmatic children

Infiltration of cells into the lung in asthma is regulated by several expressions of cell adhesion molecules (CAMs) on cells present in the airways, and may play a role in the pathogenesis of bronchial asthma. We sought to evaluate the role of serum concentrations of the soluble forms of intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), and E-selectin (sE-selectin) in the control of disease activity in acute asthma. Circulating levels of sICAM-1, sVCAM-1, and sE-selectin in sera from 15 normal control subjects and from 20 allergic asthmatic children with acute exacerbations who had returned to stable condition were determined by using commercially available enzyme-linked immunosorbent assay kits. The mean concentration of serum sICAM-1 levels was significantly higher during an acute exacerbation of asthmatic children than in those with stable asthma (19.41 +/- 10.65 ng/mL vs. 13.46 +/- 5.44 ng/mL; P < 0.001) or in control subjects (9.83 +/- 2.02 ng/mL; P < 0.001). For sVCAM-1 and sE-selectin, the mean serum concentration of sVCAM-1 was slightly higher in children during an acute exacerbation asthma than when stable. However, the differences did not reach statistical significance. The mean serum concentrations of sVCAM-1 and sE-selectin in acute asthma or stable asthma were significantly higher than in control subjects. This study provides further evidence that serum concentrations of sICAM-1, sVCAM-1, and sE-selectin are increased in acute asthma. These findings further confirm that leukocyte endothelial adhesion plays a role in inflammatory airway disease.