ACS患者动脉粥样斑块稳定性相关细胞因子变化的临床意义

目的：探讨急性冠脉综合征（ACS）病人血清中的细胞因子基质金属蛋白酶-1（MMP-1）、金属蛋白酶组织抑制剂-1（TIMP1）、sICAM-1、sVCAM-1水平与冠状动脉粥样硬化斑块稳定性的相关性及临床意义。方法：用ELISA检测ACS病人血清中sICAM-1、sVCAM-1、MMP-1、TIMP-1水平,并与正常对照组进行比较分析。结果：ACS组血清sICAM-1、sVCAM-1、MMP-1、TIMP-1水平均非常明显地高于正常对照组（P〈0.01）。结论：外周血中sICAM-1、sVCAM-1、MMP-1、TIMP-1水平增高与ACS相关,能反映冠脉粥样硬化斑块的稳定情况,可作为评价冠状动脉粥样硬化斑块稳定性与病变严重程度的一个参考指标。     

阿托伐他汀对冠心病患者外周血单核细胞/巨噬细胞清道夫受体的影响

目的：观察冠心病患者外周血单核细胞（PBMs）转化巨噬细胞清道夫受体活性及血清炎性因子(包括CRP、sICAM-1 、sVCAM-1)的变化及阿托伐他汀对清道夫受体活性的影响，探讨炎性因子水平与清道夫受体活性关系及他汀类药物稳定粥样硬化斑块的可能机制。 方法： 75例血脂正常冠心病患者分为稳定性心绞痛组、不稳定性心绞痛组、急性心肌梗死3组，29例健康人作为对照。测定所有观察对象血清C反应蛋白、可溶性细胞间黏附分子（sICAM-1）、血管细胞黏附分子（sVCAM-1）水平；并在体外分离培养PBMs并转化为巨噬细胞, 观察阿托伐他汀对其表达清道夫受体的影响。 结果： 巨噬细胞清道夫受体活性及血清C反应蛋白、sICAM-1、sVCAM-1水平，急性心肌梗死组>不稳定性心绞痛组>稳定性心绞痛组>对照组。阿托伐他汀能下调冠心病患者PBMs源性巨噬细胞清道夫受体活性。冠心病患者PBMs源性巨噬细胞清道夫受体活性与C反应蛋白、sICAM-1、sVCAM-1呈正相关。 结论： PBMs源性巨噬细胞清道夫受体活性可作为易损斑块活动程度的监测指标；阿托伐他汀可抑制冠心病患者血PBMs源性巨噬细胞清道夫受体活性。     

ACS患者血浆IL-1、IL-6及sVCAM-1、sICAM-1检测分析

急性冠脉综合征（Acute coronary syndrome,ACS）包括不稳定型心绞痛、非Q波性心肌梗死、急性Q波性心肌梗死及心脏性猝死,它是冠状动脉粥样硬化斑块由稳定转为不稳定,继而破裂,随之激活血小板、促进凝血酶形成,     

急性心肌梗塞病人细胞粘附分子与补体激活成分的动态变化

目的:探讨急性心肌梗塞(AMI)病人血浆细胞粘附分子和补体活化成分的变化。方法:采用酶联免疫吸附法(ELISA),检测了67例AMI病人发病第1、4、7d时和38例健康人,42例陈旧性心肌梗塞(OMI)病人白细胞CD18表达、血浆可溶性细胞间粘附分子-1(sICAM-1)、可溶性血管细胞间粘附分子-1(sVCAM-1)和血浆补体活化片段(sC5b-9)浓度的变化。结果:AMI病人白细胞CD18表达、sICAM-1、sVCAM-1和sC5b-9浓度非常显著高于对照组和OMI病人(P＜0.01)。发病第1-7d,白细胞CD18表达、sICAM-1、sVCAM-1和sC5b-9浓度逐渐降低。死亡者和伴有室性心律失常者各指标增高较存活者和无室性心律失常者更明显(P＜0.01)。AMI病人白细胞CD18表达、sICAM-1、sVCAM-1浓度与sC5b-9浓度呈正相关(r=0.648,0.652,0.668,0.698,0.914,0.725,0.737,0.752,0.792,P＜0.01),白细胞CD18表达与sICAM-1、sVCAM-1浓度呈正相关(r=0.662,0.683,0.695,0.738,0.744,0.745,P＜0.01)。结论:细胞粘附分子和补体激活成分的相互作用参与了AMI的发生和发展,且与病情严重程度和预后有密切关系。     

系统性红斑狼疮患者可溶性血管细胞间粘附分子-1的变化

目的：了解系统性红斑狼疮（SLE）患者血清中可溶性血管细胞间粘附分子-1（sVCAM-1）水平以及同临床病情的关系。方法：应用ELISA双抗体夹心法测定血清中VCAM-1水平，同时检测其它免疫学指标。结果：活动期SLE患者sVCAM-1水平高于稳定期和健康人，抗双链DNA抗体（抗ds-DNA抗体）阳性者或伴狼疮性肾炎病人更高；sVCAM-1水平与血沉呈显著正相关。结论：sVCAM-1可以作为SLE活动和严重程度的血清学参数，SLE发病可能与自身抗体ds-DNA使血管内皮细胞活化有关。     

冠心病人血浆可溶性细胞粘附分子和白细胞cDl8表达的动态变化

联免疫吸附法(ELISA),检测90例冠心病人外周血白细胞CD18表达、血浆可溶性细胞间粘附分子-1(slCAM-1)和可溶性血管细胞间粘附分子-1(sVCAM-1)浓度的动态变化.结果冠心病人白细胞CD18表达、slCAM-1和sVCAM-1浓度均明显增高,与对照组比较有极显著差异性(t=7.692～11.458,P<0.001),且早晨各指标的增高均较下午更明显(t=3.052～12.460,P<0.01,0.001).UA、AMI、OMI病人早晨各指标增高均较下午明显，且不同时间各指标间的比较差异亦具有显著性(F=5.826～10.945,q=6.788～9.625,P<0.01),以AMI病人各指标增高最明显.冠心病人早晨、下午白细胞CD18表达与slCAM-1和SVCAM-1浓度呈正相关(r=0.648～0.727,P<0.001).结论冠心病发病早晨高发现象与白细胞CD18 表达、sICAM-1和sICAM-1浓度动态变化有密切关系.     

可溶性细胞间粘附分子在慢性肾脏病中的变化

目的:研究慢性肾病(CKD)患者血清可溶性细胞粘附分子-1(soluble intercellular adhesion molecule-1, sICAM)的变化与临床意义.方法:用双抗体夹心ELISA方法,对52例CKD患者及20例健康对照人群的sICAM-1水平进行检测分析.52例CKD患者中,其中27例为CRF血液透析患者;25例肾功能正常CKD患者.结果:CKD组患者sICAM-1水平明显高于对照组(105.42±61.95)(P＜0.01);肾功能正常CKD组和CKD-CRF组sICAM-1水平均显著高于对照组(P＜0.01);CRF组sICAM-1水平明显低于肾功能正常CKD组(P＜0.01);但高于对照组(84.80±19.61/164.08±70.66/54.61±5.48)(P<0.01).结论:sICAM-1水平在慢性肾脏病中明显升高,CRF组病人sICAM-1水平低于CKD肾功能正常患者,提示透析过程中可能有sICAM溢出,吸附并丢失入透析液中(1),或可能是肾纤维化为主的病变使sICAM-1表达下降.     

急性冠脉综合征患者血清可溶性CD40L水平的临床研究

目的:探讨可溶性白细胞分化可溶性抗原40配体(sCD40L)和超敏C反应蛋白(hs-CRP)在急性冠脉综合征(ACS)患者发病及预后中的临床意义及机制。方法:根据急性冠脉综合征诊断标准选择86例患者,分为两组:正常对照组(NCHD)17例,ACS组69例,其中不稳定心绞痛(UA)58例,急性心肌梗死(AMI)11例,入院当天采用ELISA测定血清sCD40L浓度和hs-CRP水平。随诊2个月,观察急性心血管事件发生率。结果:ACS组明显高于对照组(P<0.01);AMI组略高于UA组但无统计学意义(P>0.05);sCD40L和或hs-CRP升高组心血管事件较正常组增多。结论:急性冠脉综合征患者早期外周血清sCD40L和hs-CRP水平明显升高,提示CD40/CD40L系统与ACS的发生有关,并与炎症因子C反应蛋白协同,对动脉粥样硬化斑块不稳定性起着重要作用。     

不稳定性心绞痛患者血管性血友病因子与血管细胞间粘附分子水平的变化

目的：探讨老年不稳定性心绞痛（UA）患者血管性血友病因子（vWF）与可溶性血管细胞间粘附分子-1（sVCAM-1）水平变化及其与心肌缺血的关系。 方法： 采用酶联免疫吸附法（ELISA），检测了50例健康人和73例UA（自发性心绞痛27例，心肌梗死后心绞痛25例，恶化劳力性心绞痛21例）患者血浆vWF、sVCAM-1浓度的变化。 结果： ①UA患者血浆vWF水平、sVCAM-1浓度［（2.47±0.88）%、（1.92±0.51）%、（961±58）μg/L、（692±73）μg/L］，明显高于对照组［（572±58）μg/L、（0.96±0.14）%］（P＜0.01）；②心绞痛发作时vWF、sVCAM-1浓度增高较缓解后更明显（P＜0.01）；③心绞痛发作时和缓解后，sVCAM-1与vWF呈正相关（r=0.785，r=0.674，P＜0.01 ）；④不同类型的心绞痛发作时和缓解后sVCAM-1、vWF浓度差异亦具有显著性（P＜0.01）；⑤自发性心绞痛患者vWF、sVCAM-1增高较心肌梗死后和恶化劳力性心绞痛更明显。 结论： 急性心肌缺血与vWF和sVCAM-1异常有一定关系。     

HBV感染不同免疫状态患者血清中可溶性细胞间粘附分子-1水平的变化

目的:探讨可溶性细胞间粘附分子-1(sICAM-1)在乙型肝炎病毒(HBV)感染不同免疫状态及HBV感染相关原发性肝癌(PHC)患者血清中的变化及其意义。方法:将HBV感染者及HBV感染相关PHC患者分为5组:HBV感染免疫耐受组80例、免疫清除组80例、免疫不全组80例(其中分免疫不全A组40例、B组40例)和PHC组80例;另选40名非HBV感染健康体检者作为正常对照组,利用ELISA法对5组者及对照组血清sICAM-1水平进行测定。结果:HBV感染不同免疫状态者中免疫清除、免疫不全B及HBV感染相关PHC患者较正常对照组有不同程度的升高,差别有统计学意义(P<0.05);免疫耐受、免疫不全A组与正常对照组相比差别无统计学意义(P>0.05)。结论:血清sICAM-1变化对于判断HBV感染不同免疫状态病情变化,有一定的临床价值。     

急性冠状动脉综合征病人外周血超敏C反应蛋白、淀粉样A蛋白和白细胞介素-6的检测和临床意义

目的:观察急性冠脉综合征(ACS)发病时急性反应蛋白中的超敏C-反应蛋白(sCRP)、淀粉样A蛋白(SAA)和白细胞介素-6(IL-6)水平的变化,旨在探讨ACS发病机制。方法:选取ACS病人80例,其中急性心肌梗死(AMI)病人40例,不稳定性心绞痛(UAP)病人40例,同时选取正常对照40例。采用酶联免疫法(ELISA)测定上述病例和对照血清中的SAA、IL-6水平,采用免疫比浊法测定血清中sCRP水平,并进行统计学分析。结果:①sCRP、SAA、IL-6水平在AMI组、UAP组显著高于对照组。②选取CK-MB粗略代表心肌坏死的程度,分别在AMI组内和UAP组内对sCRP、SAA、IL-6、纤维蛋白原和CK-MB进行Spearman等级相关分析,发现sCRP、SAA、IL-6之间存在明显相关性,并且这种相关性在UAP组强于AMI组。纤维蛋白原在AMI组中与IL-6、SAA相关,在UAP组中与sCRP相关。③无论AMI组还是UAP组,CK-MB与sCRP、SAA、IL-6、纤维蛋白原之间均无相关性。④采用Wagner 37项/29分QRS积分系统对40例AMI病人进行梗死面积的估计,结果表明QRS积分≤6分组和>6分组之间sCRP、SAA、IL-6水平无明显差异。 结论:外周血中sCRP、SAA、IL-6水平可能作为诊断和预测ACS发生的敏感指标。血清中sCRP、SAA、IL-6的升高主要不是心肌坏死的作用,可能与多病灶的不稳定斑块的存在有关。     

Maternal serum levels of VCAM-1, ICAM-1 and E-selectin in preeclampsia

Endothelial dysfunction is thought to be a central pathogenic feature in preeclampsia on the basis of elevated adhesion molecules. The aim of the present study was to compare the levels of soluble vascular cell adhesion molecule-1 (sVCAM-1), intercellular adhesion molecule-1 (sICAM-1) and E-selectin (sE-selectin) in sera of normal and preeclamptic pregnancies. We studied the serum levels of sVCAM-1, sICAM-1 and sE-selectin in normal pregnant women (n=63), mild preeclampsia (n=33) and severe preeclampsia (n=82). Concentrations of soluble adhesion molecules were determined with enzyme-linked immunoassay (ELISA). Serum concentrations of sVCAM-1 were significantly higher in both mild (p=0.004) and severe preeclampsia (p=0.000) than normal pregnancy. There were also significant differences in sVCAM- 1 levels between mild and severe preeclampsia (p=0.002). sICAM-1 levels of severe preeclampsia were statistically different from those of normal pregnancy (p=0.038). Levels of sE-selectin were elevated in both mild (p=0.011) and severe preeclampsia (p=0.000) compared to normal pregnancy, but no statistical difference between the mild and severe preeclampsia (p=0.345). These results suggest that all three soluble adhesion molecules are increased in severe preeclampsia, and sVCAM-1 among them may be useful in predicting the severity of preeclampsia.     

Levels of intracellular adhesion molecule-1 and vascular cell adhesion molecule-1 in children with Henoch-Sch?nlein purpura.

BACKGROUND AND PURPOSE: Henoch-Sch?nlein purpura (HSP) is a small vessel vasculitis. Soluble adhesion molecules play a very important role in the immuno-inflammatory reaction of damaged vascular tissues. This study investigated the prognostic and diagnostic potential of soluble intracellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) in HSP. METHODS: Serum levels of sICAM-1 and sVCAM-1 were studied in 26 children with HSP. Paired blood samples (during acute and convalescent stages) were collected from 17 of the children and assayed by enzyme-linked immunosorbent assay. Correlations with clinical manifestations were examined. Seventeen healthy children served as controls. RESULTS: Both sICAM-1 and sVCAM-1 were significantly elevated at the acute stage compared with the remission stage of HSP patients versus controls (p=0.006 and p=0.0173, respectively). CONCLUSIONS: Although the levels of sICAM-1 and sVCAM-1 were not correlated with the severity of clinical manifestations in HSP, these soluble adhesion molecules may serve as diagnostic markers.     

IL-18、IL-10和IL-6与急性冠状动脉综合征的关系研究

目的：研究白细胞介素（IL）-18、IL-10和IL-6血清浓度与急性冠状动脉综合征之间的关系。方法： 采用酶联免疫吸附法（ELISA）和放射免疫法检测62例冠心病患者（急性心肌梗死17例、不稳定性心绞痛30例、稳定性心绞痛15例）和20例正常健康者血清IL-18、IL-10和IL-6水平，并比较上述指标水平之间的相关关系。 结果： 血清IL-18、IL-6水平在急性心肌梗死（AMI）组和不稳定性心绞痛（UAP）组显著高于稳定性心绞痛（SAP）组和对照组(P＜0.05, P＜0.01)；AMI组和UAP组血清IL-10水平明显低于SAP组和对照组（P＜0.01）。血清IL-18和IL-6水平与血清IL-10水平呈显著负相关（r＝－0.827, P＜0.01; r＝－0.231, P＜0.05)； 血清IL-6水平与IL-18水平相关性不明显（r＝0.119, P＞0.05）。 结论： 急性冠状动脉综合征患者血清IL-18、IL-6水平明显升高而IL-10水平显著降低；IL-18、IL-6与IL-10的平衡失调可能是促进斑块不稳定的重要因素。     

Serum levels of soluble intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and interleukin-2 receptor in patients with vernal keratoconjunctivitis and allergic conjunctivitis

BACKGROUND: Vernal keratoconjunctivitis (VKC) is characterized by severe ocular allergic inflammation that may have a poor visual prognosis. Due to the high frequency of the presence of atopic dermatitis (AD) in VKC, most systemic parameters are dependent on the clinical severity of AD. METHODS: Serum levels of sICAM-1, sVCAM-1, and sIL-2R were measured by enzyme-linked immunoassay using samples from 30 VKC patients, 30 allergic conjunctivitis (AC) patients, and 20 normal subjects, to determine whether the concentrations of these molecules are elevated. RESULTS: Circulating sICAM-1 and sIL-2R levels were increased in patients with VKC with AD compared with those in VKC without AD, AC, and normal controls. Serum levels of sVCAM-1 in VKC patients with and without AD were significantly higher than those in controls. No significant difference was found in the levels of sVCAM-1 between patients with VKC with and without AD. In VKC patients with AD, the sIL-2R level correlated significantly with severity of AD, whereas no such correlation was found for sICAM-1 and sVCAM-1. CONCLUSIONS: These results suggest that serum sVCAM-1 can be used as a marker to differentiate VKC from nonproliferative ocular allergic diseases, and specific immunologic features of VKC may underlie the upregulation of serum sVCAM-1.     

血清腱糖蛋白-C、hs-CRP与急性冠脉综合症的相关性分析

目的 通过观察血清腱糖蛋白-C(TN-C)和高敏C反应蛋白(hs-CRP)在不同类型急性冠状动脉综合征患者血中表达水平,探讨二者与不同类型冠脉综合征的相关性.方法 总共入组诊断为急性冠脉综合症的患者90例,进一步分为两组:急性心肌梗死(AMI)组(n=48),不稳定性心绞痛(UAP)组(n=42),以及另入组稳定性心绞痛60例稳定心绞痛(SAP)组,及健康体检者55例为对照组.采用酶联免疫吸附试验(ELISA法)、放射免疫法分别测定血清TN-C和hs-CRP水平,并在各组间进行比较.结果 AMI组和UAP组TN-C表达水平明显高于SAP组、对照组,差异有统计学意义(P＜0.05);SAP组TN-C水平高于对照组但差异无统计学意义(P＞0.05).AMI组、UAP组和SAP组hs-CRP水平明显高于对照组,差异有统计学意义(均P＜0.05),而AMI组和UAP组hs-CRP较SAP相比差异无统计学意义(均P＞0.05).结论 TN-C、hs-CRP在ACS患者血清中升高,TN-C可作为急性冠状动脉综合征斑块稳定性病变严重程度的预测因子.     

冠心病患者血清hs-CRP和E-Selectin检测的临床意义

目的:探讨了冠心病患者血清超敏C反应蛋白(hs-CRP)和E-选择素(E-Selectin)水平的变化及意义.方法:应用免疫比浊法检测hs-CRP,ELISA法检测E-Selectin水平对58例冠心病患者进行了血清hs-CRP,E-Selectin水平检测.其中稳定型心绞痛25例,不稳定型心绞痛20例,急性心肌梗死13例,并以35名正常健康人作比较.结果:冠心病患者血清hs-CRP和E-Selectin水平明显高于正常人组(P＜0.01),急性心肌梗死组和不稳定型心绞痛组有明显高于稳定型心绞痛组(P＜0.01),冠心病组血清hs-CRP、E-Selectin水平与冠状动脉狭窄程度无明显相关性(P＞0.05).结论:血清hs-CRP和E-Selectin水平的变化与冠心病的发生、发展有关,但与冠状动脉狭窄程度无关.     

Microplate ELISAs for soluble VCAM-1 and ICAM-1

Soluble vascular cell adhesion molecule (sVCAM-1) and soluble intercellular adhesion molecule (sICAM-1) are adhesion molecules that are detectable in the serum of patients with cancer, cardiovascular diseases (CVD), and type 2 diabetes. This report describes enzyme-linked immunosorbent assays (ELISAs) on microplates for sVCAM-1 and sICAM-1. The ELISAs have the sandwich test format; polyclonal antibodies are coated on microwells and a one-step procedure is used in which the serum specimen and detecting antibody are added simultaneously to an antibody-coated well. These assays both use HRP-conjugated sheep anti-mouse-IgG to generate the color for quantification. Sensitivities for detecting sVCAM-1 and sICAM-1 are 49 and 40 ng/ml, respectively. Coefficients of variation for within-day and day-to-day replicate analyses are <10%. Results by these in-house ELISAs for serum sVCAM-1 and sICAM-1 compared well with those obtained with commercial kits from R&D Systems, Inc. (correlation coefficients = 0.98 and 0.99 for sVCAM-1 and sICAM-1, respectively). Reference values for serum sVCAM-1 and sICAM-1 levels were measured in 369 apparently healthy Chinese adults, age 30 to 79 yr. There was no significant effect of gender on the reference values for sVCAM-1 or sICAM-1. Serum sVCAM-1 levels (mean +/- SD) were higher in subjects 60 yr old (625 +/- 126 ng/ml), compared to those <60 yr old (525 +/- 110 ng/ml) (p <0.001). Age did not significantly affect the reference values for serum sICAM-1 levels (mean +/- SD, 249 +/- 86 ng/ml). The authors believe that these simple, inexpensive ELISAs will be useful for assessing the risks for development of cancer, CVD, and type 2 diabetes.     

Delay of neutrophil apoptosis in acute coronary syndromes

Apoptosis of polymorphonuclear neutrophils (PMN) is currently discussed as a key event in the control of inflammation. This study determined PMN apoptosis and its underlying mechanisms in controls (C), patients with stable (SAP) or unstable angina (UAP), and with acute myocardial infarction (AMI). Blood was drawn from 15 subjects of each C, SAP, UAP, and AMI. Apoptosis was measured by flow cytometry in isolated PMN (propidium iodide staining) and PMN from whole blood (CD16, FcgammaRIII). Serum cytokines were determined by enzyme-linked immunosorbent assay. Apoptosis of isolated PMN was delayed significantly in acute coronary syndromes (ACS) as compared with SAP or C (C, 51.2+/-12.6%; SAP, 44.9+/-13.6%; UAP, 28.4+/-10.1%; AMI, 20.3+/-8.5%; AMI or UAP vs. SAP or C, P<0.001). These results were confirmed by measurement of PMN apoptosis in cultured whole blood from patients and controls. Moreover, serum of patients with ACS markedly reduced apoptosis of PMN from healthy donors. Analysis of patients' sera revealed significantly elevated concentrations of tumor necrosis factor alpha, interferon-gamma (IFN-gamma), granulocyte macrophage-colony stimulating factor (GM-CSF), and interleukin (IL)-1beta in ACS (vs. C and SAP). IFN-gamma, GM-CSF, and IL-1beta significantly delayed PMN apoptosis in vitro. Furthermore, coincubation of PMN with adenosine 5'-diphosphate-activated platelets significantly inhibited PMN apoptosis as compared with coculture with unstimulated platelets. This study demonstrates a pronounced delay of PMN apoptosis in UAP and AMI, which may result from increased serum levels of IFN-gamma, GM-CSF, and IL-1beta and from enhanced platelet activation. Therapeutical modulation of these determinants of PMN lifespan may provide a new concept for the control of inflammation in ACS.