Молекулы адгезии при тяжелом течении атеротромботического инсульта

Abstract Introduction . Atherothrombotic stroke represents 34% of stroke cases among all the subtypes of ischemic stroke. Adhesion molecules are proteins associated with the basal membrane. They contribute to the intensification of adhesion processes, hyperaggregation of blood cells and microcirculation disorders. Objective. To investigate the blood levels of adhesion molecules in patients with severe atherothrombotic stroke. Materials and methods. For the study, we recruited 21 patients (mean age, 67 [61; 73] years) with atherothrombotic stroke in the  carotid system who were observed for the initial 48 hours since the development of neurological symptoms. The patients were categorized as severe stroke based on the total NIHSS score (Me 15 [14; 18]) at the time of admission. The spectrum of soluble cellular adhesion molecules as immunological markers of endothelial dysfunction was studied. Results. Increased levels of sICAM-1, sPECAM-1, sР-selectin, sЕ-selectin and sVCAM-1 were revealed at the beginning of the acute period of atherothrombotic stroke. By the day 21, a decrease of sPselectin, sE-selectin and sVCAM-1 was seen, and this phenomenon was probably caused by effects of blood antiplatelet therapy and statins on cellular adhesion. Positive correlation was established between the VCAM-1 during the first 48 hours of atherothrombotic stroke and the severity of neurologic deficit by the day 21. In the subgroup of patients with lethal outcomes, sICAM-1 and sVCAM-1 levels were higher in comparison with patients with severe disability. Conclusion. Elevated expression of sVCAM-1 in the first 48 hours of atherothrombotic stroke is associated with severe neurologic deficit by the day 21 of stroke. The high levels of sICAM-1 and sVCAM-1 upon admission may be regarded as risk factors for lethal outcomes.