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Cell adhesion molecules - can they be used to predict coronary artery disease in patients with familial
J E Paiker1, F J Raal, M Veller
1Department of Chemical Pathology, South African Institute for Medical Research and University of the Witwatersrand, Johannesburg, South Africa. 158jan@chiron.wits.ac.za
Insights
Soluble cell adhesion molecules (CAMS) like VCAM, ICAM, and E-selectin do not predict atherosclerosis in familial hypercholesterolemia (FH) patients. Levels were not elevated and showed significant overlap with controls, limiting their use as biomarkers.
Area of Science:
- Cardiovascular Science
- Immunology
- Biochemistry
Background:
- Leukocyte adhesion via cell adhesion molecules (CAMS) is crucial in atherosclerosis initiation.
- Familial hypercholesterolemia (FH) patients have a high risk of premature coronary artery disease (CAD).
Purpose of the Study:
- To evaluate soluble VCAM, ICAM, and E-selectin as predictive markers for atherosclerosis presence and severity in FH patients.
- To assess the diagnostic utility of these CAMS in distinguishing FH patients with and without CAD.
Main Methods:
- Studied 20 heterozygous FH patients without CAD, 24 with CAD, 17 homozygous FH patients without CAD, 9 with CAD, and 50 controls.
- Measured serum levels of soluble VCAM, ICAM, and E-selectin.
- Assessed carotid artery intima-media thickness (IMT) in homozygous FH patients.
Main Results:
- Soluble VCAM, ICAM, and E-selectin levels were not significantly elevated in FH patients (heterozygous or homozygous) compared to controls.
- No significant difference in CAMS levels was observed between FH patients with and without CAD.
- Wide variations and substantial overlap in CAMS levels between FH patients and controls were noted.
Conclusions:
- Soluble VCAM, ICAM, and E-selectin are not effective predictive markers for atherosclerosis presence or severity in familial hypercholesterolemia.
- Individual CAMS levels lack diagnostic value for assessing atherosclerosis in FH patients due to high variability and overlap with normal populations.
Abstract:
Adhesion of leukocytes to endothelial cells via cell adhesion molecules (CAMS) is thought to be pivotal in the initiation of atherosclerosis. As patients with familial hypercholesterolaemia (FH) are known to develop severe, premature coronary artery disease (CAD), we investigated the usefulness of soluble forms of CAMS namely vascular cellular adhesion molecule-1 (VCAM), intercellular cell adhesion molecule-1 (ICAM) and E-selectin as predictive markers of the presence and severity of atherosclerosis in this patient group. Twenty heterozygous FH patients without CAD; 24 heterozygous FH patients with CAD; 17 homozygous FH patients without documented CAD; nine homozygous FH patients with overt CAD; and 50 healthy controls were studied. Carotid artery intima media thickness (IMT) was also measured in the homozygous patients. Levels of the adhesion molecules VCAM, ICAM and E-selectin were not significantly elevated in homozygous FH patients and heterozygous FH patients, both with and without CAD, compared to the normal control subjects. In addition the range of results was so wide and the overlap of values with normal controls so great, that the use of an individual level of either VCAM, ICAM or E-selectin was not predictive of either the presence or degree of atherosclerosis in the FH subjects.
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