Increased release of the soluble form of the adhesion molecules L-selectin and ICAM-1 but not E-selectin during attacks of angina pectoris

Abstract

Myocardial ischemia leads to the activation of neutrophils as well as endothelial cells. The interaction between these cells is dependent on certain adhesion glycoproteins which are expressed on their surface. Adhesion of neutrophils to endothelium, mediated by adhesion molecules, has been shown to result in coronary capillary plugging and impairment of coronary blood flow. In certain conditions, upon cell activation, adhesion proteins may be released in soluble form into the circulating blood. The purpose of our study was to verify whether myocardial ischemia occurring during angina episodes results in the release of the soluble adhesion molecules, L-selectin, E-selectin, and intracellular adhesion molecule-1 (ICAM-1), into the circulation. Plasma samples were collected by venepuncture from 15 patients admitted to the emergency room with chest pain caused by attacks of angina pectoris and 15 patients with noncardiac chest pain. To confirm the diagnosis, all patients underwent an exercise stress test and, if not conclusive, 99mTc MIBI SPECT or coronary arteriography. Another set of plasma samples were taken from each patient in the absence of chest pain. In addition, blood for analysis was obtained from 15 sex-and age-matched healthy subjects. Soluble adhesion molecules plasma levels were measured by standard enzyme-linked immunosorbent assay. In patients with angina pectoris, plasma levels of soluble L-selectin estimated during chest pain were significantly higher than in the control group and decreased in the absence of chest pain. Similarly, the mean concentration of soluble ICAM-1 at the time of angina onset was significantly elevated in the patients in comparison with the control group and remained higher, although not significantly, in the absence of chest pain. In patients with noncardiac chest pain, plasma levels of soluble L-selectin did not differ significantly from those observed in control subjects. In this group of patients, the plasma levels of soluble ICAM-1 estimated during pain onset and in the absence of this symptom were not significantly elevated. On the contrary, the mean values of soluble E-selectin in the patients with ischemic cardiac pain during chest pain and in the absence of this symptom, as well as those in the patients with noncardiac chest pain during or without symptoms, remained unchanged in comparison with the control group. During attacks of angina pectoris an increase in the plasma levels of the soluble adhesion molecules, ICAM-1 and L-selectin, was noted, possibly reflecting activation of neutrophils and endothelial cells during myocardial ischemia. However, E-selectin plasma levels remained unchanged in response to myocardial ischemia.

Endothelial cell dysfunction after coronary artery bypass grafting with extracorporeal circulation in patients with type 2 diabetes mellitus

“…the release of cytokines and soluble adhesion molecules during and after CPB, is well documented in clinical studies [13,14]. However, diabetic patients were mostly excluded in these investigations for an assumed endothelial dysfunction.…”

Plasma and serum L-selectin and clinical and subclinical cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis (MESA)

“…In fact, circulating L-selectin was found to be protective in some studies, 7–9 and a risk factor in others. 10,13–16 The previous body of literature is almost exclusively represented by case-control studies from predominantly Caucasian clinical populations with only a single L-selectin measurement (ie, serum or plasma).…”

“…11,12 In addition, in plasma, L-selectin levels were higher in patients with unstable angina 13–15 and PAD 16 compared to controls and levels were lowered by statin therapy in a group of hyperlipidemic patients, 17 suggesting a pro-inflammatory role of the circulating protein.…”

Toll-like receptor and its roles in myocardial ischemic/reperfusion injury

“…Appleyard and Cohn, deploying a sheep model, showed that myocardial stunning induced by cardiac I/R can be attenuated by blocking neutrophil-endothelial cell interaction with ICAM-1 receptors [128]. Siminiak reported that administration of antibodies that block the function of adhesion molecules attenuated PMN-mediated tissue destruction during on-pump CABG surgery [129]. In summary, ICAM-1 actually mediates cardiomyocyte damage via neutrophil-endothelial cell interaction after cardiac I/R.…”