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Endothelial cell activation is associated with cerebral white matter lesions in patients with cerebrovascular disease

F-E de Leeuw1, M de Kleine, C J M Frijns

  • 1Departments of Neurology, University Medical Center Utrecht, C03-236, PO Box 85500, 3508 GA Utrecht, the Netherlands. h.f.deleeuw@neuro.azu.nl

Annals of the New York Academy of Sciences
|December 14, 2002
PubMed

Insights

Endothelial cell activation, indicated by elevated sP-selectin and sVCAM-1, is linked to periventricular white matter lesions in patients with carotid artery stenosis. This suggests a role for vascular factors in small vessel disease progression.

Area of Science:

  • Neurology
  • Vascular Biology
  • Medical Imaging

Background:

  • White matter lesions are common in the elderly, associated with cognitive decline and dementia.
  • While vascular risk factors are implicated, the precise pathogenesis of white matter lesions remains unclear.
  • Animal studies suggest endothelial cell involvement in white matter lesions and dementia.

Purpose of the Study:

  • To investigate the relationship between endothelial cell activation markers and white matter lesions in patients with cerebrovascular disease.
  • To explore the role of specific adhesion molecules in the development of white matter lesions.

Main Methods:

  • Assessed endothelial cell activation markers (sICAM-1, sVCAM-1, sE-selectin, sP-selectin) using ELISA in 29 patients with stroke or TIA.
  • Performed 1.5-T MRI scans to evaluate periventricular and subcortical white matter lesions.
  • Correlated adhesion molecule levels with the severity of white matter lesions.

Main Results:

  • Severe periventricular white matter lesions correlated with higher levels of sP-selectin and sVCAM-1.
  • This association was specific to patients with symptomatic carotid artery stenosis.
  • No significant association was found between endothelial markers and subcortical white matter lesions, nor with sICAM-1 or sE-selectin.

Conclusions:

  • Endothelial cell activation, particularly involving sP-selectin and sVCAM-1, may contribute to periventricular white matter lesions.
  • This suggests vascular factors influence cerebral endothelium, potentially preceding small vessel disease progression.
  • Findings highlight the importance of endothelial function in cerebrovascular health.

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