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Soluble E-selectin, ICAM-1 and VCAM-1 levels in systemic and coronary circulation in patients with variant angina
1Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan.
Insights
Plasma levels of soluble E-selectin and intercellular adhesion molecule-1 (ICAM-1) are elevated in variant angina patients, suggesting inflammation. These molecules are released in the coronary circulation after spasm.
Area of Science:
- Cardiology
- Immunology
- Biochemistry
Background:
- Variant angina is associated with coronary artery spasm.
- Adhesion molecules play a role in inflammatory processes and vascular events.
Purpose of the Study:
- To investigate elevated plasma levels of soluble adhesion molecules (E-selectin, ICAM-1, VCAM-1) in variant angina patients.
- To determine if these molecules are released within the coronary circulation.
Main Methods:
- Plasma samples collected from patients with variant angina, stable effort angina, and controls.
- Coronary sinus and aortic root samples taken during induced spasm in variant angina patients.
- Enzyme immunoassay used to quantify soluble adhesion molecules.
Main Results:
- Elevated plasma E-selectin and ICAM-1 in variant angina compared to controls.
- Higher ICAM-1 in variant angina versus stable angina.
- ICAM-1 and VCAM-1 levels changed in coronary circulation after spasm induction.
Conclusions:
- Elevated soluble E-selectin and ICAM-1 indicate an inflammatory link to coronary spasm.
- ICAM-1 and VCAM-1 are released from the coronary circulation post-spasm and reperfusion.
Objective:
The purpose of this study was to assess whether the plasma levels of soluble adhesion molecules including E-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) are elevated in patients with variant angina and whether they are released in the coronary circulation.
Methods:
Antecubital venous plasma samples were collected from 33 patients with variant angina, 22 patients with stable effort angina and 20 control subjects. Samples were also collected from the aortic root (AO) and the coronary sinus (CS) in 18 patients with variant angina before and after left coronary spasm induced by intracoronary injection of acetylcholine. The soluble adhesion molecules were assayed by enzyme immunoassay.
Results:
Antecubital venous plasma soluble E-selectin (P < .05), ICAM-1 (P < .01) and VCAM-1 (NS) levels were higher in the variant angina group than in the control group, respectively. The plasma soluble ICAM-1 level was also higher (P < .01) in the variant angina group than in the stable effort angina group. In the variant angina group, both soluble ICAM-1 (P < .05) and VCAM-1 (P < .01) levels were significantly lower in CS than AO at baseline. In contrast, after the spasm the plasma soluble ICAM-1 level was (P < .05) higher in CS than AO and the CS-AO differences of soluble ICAM-1 (P < .05) and VCAM-1 (P < .05) increased as compared with the baseline, respectively. These values were remained unchanged in the stable effort angina group after rapid atrial pacing and in the control group after administration of acetylcholine.
Conclusions:
Circulating plasma levels of both soluble E-selectin and ICAM-1 were elevated in patients with variant angina, indicating an association of an inflammatory reaction with coronary spasm. Both soluble ICAM-1 and VCAM-1 appeared to be trapped in the coronary circulation at baseline and released into the coronary circulation following coronary spasm and reperfusion in the patients.