Associations between endothelial inflammatory markers and cerebral small vessel disease in a community-based
Zhang Xia1,2, Lingling Jiang1,2, Xueli Cai3
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Insights
Vascular cell adhesion molecule 1 (VCAM-1) is linked to cerebral small vessel disease (CSVD) presence and severity. Intercellular adhesion molecule 1 (ICAM-1) showed no association with CSVD, indicating VCAM-1
Area of Science:
- Neuroscience
- Cardiovascular Science
- Biomarkers
Background:
- Endothelial inflammation plays a key role in the pathogenesis of cerebral small vessel disease (CSVD).
- Vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1) are established biomarkers indicating endothelial inflammation.
Purpose of the Study:
- To investigate the association between VCAM-1 and ICAM-1 levels and the presence and burden of CSVD.
- To assess the predictive value of these biomarkers for CSVD and cognitive impairment within the CSVD context.
Main Methods:
- A cross-sectional study involving 2596 community residents from the PRECISE study.
- Assay of VCAM-1 and ICAM-1 levels in fasting venous blood samples.
- Assessment of cognitive function using the Montreal Cognitive Assessment (MoCA) and evaluation of CSVD markers (white matter hyperintensity, lacunes, microbleeds, enlarged perivascular spaces) via 3.0T MRI.
Main Results:
- Elevated VCAM-1 levels were significantly associated with an increased likelihood of CSVD presence (OR=1.16) and higher CSVD burden (cOR=1.11-1.16).
- VCAM-1 demonstrated improved prediction for CSVD presence and cognition-impaired CSVD.
- ICAM-1 levels did not show a significant association with CSVD presence or burden, nor did they improve predictive models.
Conclusions:
- Endothelial inflammation, specifically indicated by elevated VCAM-1, is significantly associated with the presence and increased burden of cerebral small vessel disease.
- VCAM-1 serves as a potential biomarker for identifying individuals with CSVD and assessing disease severity, whereas ICAM-1 does not appear to be a relevant marker in this context.
Background:
Endothelial inflammation is involved in cerebral small vessel disease (CSVD) pathogenesis. Vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1) are biomarkers of endothelial inflammation.
Aims:
This study investigated the association of VCAM-1 and ICAM-1 with the presence of CSVD and CSVD burden.
Methods:
This cross-sectional study included community residents from the Polyvascular Evaluation for Cognitive Impairment and Vascular Events (PRECISE) study. Fasting venous blood was drawn to assay VCAM-1 and ICAM-1. Cognition was assessed by the Montreal Cognitive Assessment (MoCA). Cognitive impairment was defined as MoCA scores < 26. White matter hyperintensity, lacunes, cerebral microbleeds, and enlarged perivascular spaces were evaluated in a 3.0T MRI scanner. CSVD burden was rated according to the criteria of Wardlaw's (score 0-4) and Rothwell's (score 0-6), and classified into four grades. Presence of CSVD was defined as CSVD burden score ⩾ 1.
Results:
This study included 2596 participants with a mean age of 61.2 ± 6.7 years and 50.9% of males. Elevated VCAM-1 was associated with increased odds of presence of CSVD (Rothwell: odds ratio (OR) = 1.16, 95% confidence interval (CI): 1.06-1.26, P = 0.001), higher CSVD burden (Wardlaw: common OR (cOR) = 1.11, 95% CI: 1.02-1.21, P = 0.02; Rothwell: cOR = 1.16, 95% CI: 1.07-1.25, P < 0.001), and presence of cognition-impaired CSVD (Rothwell: OR = 1.15, 95% CI: 1.05-1.25, P = 0.003). VCAM-1 improved net reclassification index and integrated discrimination improvement for the presence of CSVD (Rothwell) and cognition-impaired CSVD (Rothwell). However, ICAM-1 was not associated with CSVD and did not improve prediction of CSVD.
Conclusion:
Endothelial inflammation, especially VCAM-1, was associated with the presence of CSVD and higher CSVD burden.
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