[Detection and clinical significance of vascular cell adhesion molecules-1 in chronic obstructive pulmonary disease]

To explore the role of soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble platelet endothelial cell adhesion molecular-1 (sPECAM-1) of prethrombotic state mediators in patients with chronic obstructive pulmonary disease (COPD).

The blood plasma levels of D-dimer (D-D), sVCAM-1 and sPECAM-1 in 20 healthy volunteers (control group) and 35 patients with acute exacerbation of COPD ( AECOPD) before and after treatment were measured by ELISA. The statistical analysis used Student' s t test of significance and Pearson linear correlation analysis.

The level of D-D in patients before treatment [(4.49 +/- 1.47) mg/L] was significantly higher than that after treatment [(1.98 +/- 0.92) mg/L] and that of the control group [(0.44 +/- 0.14) mg/L] (t = 0.91, 13.10, both P < 0.001); the level of D-D in patients after treatment was also higher than that of the control group (t = 4.96, P < 0.001). The level of sVCAM-1 in patients before treatment [(11 +/- 5) nmol/L] was significantly higher than those of patients after treatment [(8 +/- 4) nmol/L] and control group [(7 +/- 4) nmol/L] (t = 2. 24, 2.75, both P < 0.001); but the difference of sVCAM-l between the post-treatment group and the control group was not significant (t = 0.75, P > 0.05). The level of sPECAM-1 in patients after treatment [(61 +/- 13) pmol/L] was significantly higher than that before treatment [(36 +/- 8) pmol/L] and that of the control group [(43 +/- 10) pmol/L] (t = 9.23, 5.91, both P < 0.001), and the level of the control group was also higher than that of patients before treatment (t = 2.35, P < 0.05). Before treatment, there was significant positive correlation between D-D and sVCAM-1 (r = 0.759, P < 0.01) but no correlation between sPECAM-1 and D-D or sVCAM-1 (r = 0.045, 0.078, both P > 0.05). After treatment, there was significant negative correlation between D-D and sPECAM-1 (r = -0.548, P < 0.01) but no correlation between sVCAM-land D-D or sPECAM-1 (r = -0.032, 0.143, both P > 0.05). There were no correlations among D-D and sPECAM-1 and sVCAM-1 respectively in the control group (r = 0.137, -0.121, 0.035, all P > 0.05).

The levels of D-D and sVCAM-1 increase significantly during acute exacerbation of COPD, which suggests that prethrombotic state exists in acute exacerbation of COPD. The measurement of D-D and sVCAM-1 is useful to monitor prethrombotic state during acute exacerbation of COPD and may be useful in evaluating the severity. The significant increase of sPECAM-1 in plasma of patients after treatment suggests that sPECAM-1 may be a protective factor against prethrombotic state.