Intercellular Cell Adhesion Molecule-1 Levels Research Articles

Probing antiphospholipid-mediated thrombosis: the interplay between anticardiolipin antibodies and endothelial cells.

The association of antiphospholipid (aPL) antibodies with thrombosis in patients with antiphospholipid syndrome (APS) is well documented in humans and in animal studies. However, the mechanisms by which aPL antibodies induce thrombosis are the subject of much current study. It has been suggested that aPL may activate endothelial cells (ECs), thus creating a hypercoagulable state that precedes and contributes to thrombosis in patients with APS. Several studies have shown that aPL upregulate ECs' adhesion molecules (CAMs): intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin (E-sel) or induce tissue factor (TF) in monocytes in vitro. Similarly, the incubation of EC with antibodies reacting with beta2glycoprotein I (beta2GPI) has been shown to induce EC activation with concomitant upregulation of CAMs, IL-6 production and alteration of prostaglandin metabolism. Our group has shown that aPL-mediated upregulation of adhesion molecules on ECs correlates with an increased adhesion of leukocytes to endothelium in the microcirculation of mouse cremaster muscle, a n indication of EC activation in vivo, andwith enhanced thrombosis in vivo. In another series of studies, investigators have shown that upregulation of expression of adhesion molecules by some murine monoclonal anti-beta2glycoprotein I (anti-beta2GPI) antibodies correlated with fetal resorption in mice in vivo. More recently, one study showed that the anti-hypercholesterolaemic drug fluvastatin inhibited the aPL-mediated enhanced adhesion of monocytes to ECs in vitro. Data from our laboratories indicate that fluvastatin also reverses thrombus formation and activation of EC induced by aPL in an in vivo mouse model. As additional support for the hypothesis that aPL antibodies activate ECs and may create an hypercoagulable state in APS patients, two recent studies indicated that levels of soluble ICAM-1 and VCAM-1 were significantly increased in the plasma of patients with APS and recurrent thrombosis. Furthermore, studies utilizing knockout mice and specific monoclonal anti-VCAM-1 antibodies have demonstrated that expression of ICAM-1, P-selectin, E-selectin and VCAM-1 are important in in vivo aPL-mediated thrombosis and EC activation in mice. Recent data suggests that aPL antibodies also induce expression of TF not only in monocytes but in ECs. Hence, the interference of aPL with the TF mechanism may be another important mechanism by which these antibodies create a hypercoagulable state and prone patients to thrombosis. Specifically, how aPL alters EC activation state and the molecular and intracellular mechanisms involved have not yet been defined. APL may interact with specific cell surface receptors (proteins and/or lipids) induce signals that have consequences downstream, and that ultimately will result in upregulation of cell surface proteins (i.e., CAMs and TF) and subsequently induce EC activation. In that regard, our group recently showed that aPL-mediated upregulation of adhesion molecules in ECs is preceded by activation of the nuclear factor kappa B (NFkappaB). Other intracellular mechanisms triggered by aPL are not completely understood and are the subject of current investigation. In conclusion, studies suggest that activation of ECs by aPL is an important mechanism that may precede thrombus formation in patients with APS. Hence, the interplay between aPL antibodies and ECs is important inthe pathogenesis of thrombosis in APS.

Evidence of impaired microvascular function in pre-eclampsia: a non-invasive study

The clinical presentation of pre-eclampsia suggests that microvascular dysfunction may play a role in the maternal manifestations of the disease. Isovolumetric venous pressure (PVi) is an index of microvascular function, reflecting local plasma colloid osmotic (oncotic) pressure, and is abnormal in clinical conditions with microvascular dysfunction. We hypothesized that, in pre-eclampsia, post-capillary margination of neutrophils would increase post-capillary resistance, and therefore PVi. A small cumulative step strain-gauge plethysmography protocol was used to compare PVi in 18 women with pre-eclampsia, 16 normal pregnant women and 17 non-pregnant controls. Circulating levels of vascular cell-adhesion molecule-1 (VCAM-1), intercellular cell-adhesion molecule-1 (ICAM-1) and E-selectin, and neutrophil elastase, were measured to assess endothelial and neutrophil activation respectively. PVi was significantly greater in the pre-eclampsia group, relative to the normal pregnant and non-pregnant controls (P<0.001, ANOVA, for both comparisons). PVi was significantly lower during normal pregnancy compared with the non-pregnant controls (P = 0.001). Plasma levels of neutrophil elastase, VCAM-1, ICAM-1 and E-selectin (P = 0.001) were significantly greater in the pre-eclamptics than the controls. Significant positive correlations were observed between PVi and neutrophil elastase (r = 0.71, P = 0.001), VCAM-1 (r = 0.52, P = 0.03), ICAM-1 (r = 0.67, P = 0.002), E-selectin (r = 0.69, P = 0.001), uric acid levels (r = 0.54, P = 0.02) and haematocrit (r = 0.64, P = 0.004) in pre-eclampsia. The relationship with the platelet count was negative (r =-0.65, P = 0.003). No significant correlations were observed between PVi and maternal age, gestational age, total protein, albumin, diastolic blood pressures, age, body mass index and infant birth mass in the normal pregnant and non-pregnant controls. These data suggest that microvascular dysfunction occurs in pre-eclampsia, and that it is related to alterations in endothelial cell and neutrophil activation.

Soluble Adhesion Molecules and the Search for Biomarkers for Atherosclerosis

Advances in the understanding of the molecular basis of inflammation, atherogenesis, and plaque instability have led to the identification of a number of molecules that are posited to play a critical role in various aspects of atherosclerotic lesions and/or their lability, which can be measured quantitatively in plasma. Intercellular cell adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1 (VCAM-1) are two important members of the immunoglobulin gene superfamily that play important but different roles in the adhesion of leukocytes to the vascular endothelium. VCAM-1, which is the endothelial ligand for α4β 1 (very late antigen 4 [VLA-4]), has been postulated to play the more critical role in monocyte adherence to endothelial cells under flow conditions. ICAM-1 ligands include CD11a/CD18 (LFA-1) and CD11b/CD18 (Mac-1), which are present on monocytes, lymphocytes, and neutrophils. Increased expression of ICAM-1 and VCAM-1 is observed in atherosclerotic lesions, and mice deficient in either ICAM-1 or VCAM-1 have reduced response to experimental atherosclerotic stimuli (eg, apolipoprotein E deletion). In the mouse, a deficiency of VCAM-1 seems to play a more important role in the initiation of atherosclerosis than does a deficiency of ICAM-1.1 Although membrane-bound forms of either adhesion molecule are difficult to measure in vivo, soluble forms can be detected in the serum or plasma and are increased in many conditions with an inflammatory component.2 The levels of soluble ICAM-1 (sICAM-1) in apolipoprotein E-deficient mice increases over time in parallel with the progression of atherosclerosis, providing evidence in a murine model that sICAM-1 may correlate with the burden of atherosclerosis.3 See p 820 On the basis of this information, a number of clinical investigators have measured levels of sICAM-1 …

Effect of NADPH oxidase inhibition on E-selectin expression induced by concomitant anoxia/reoxygenation and TNF-alpha.

The aim of this study was to quantify the expression of E-selectin, intercellular cell adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) in human umbilical vascular endothelial cells (HUVECs) exposed to anoxia/reoxygenation (A/R) in the presence or absence of an inflammatory context (0.1 IU/ml tumor necrosis factor-alpha [TNF-alpha]) and to investigate the effects of two different NADPH inhibitors, apocynin and diphenyleneiodonium (DPI), on the expression of the endothelial cell adhesion molecules. Confluent HUVECs were exposed to anoxia for 3 hours (100% N2), followed by a reoxygenation period of 4 hours. TNF-alpha at 0.1 IU/ml was added to the medium either under normoxic conditions for 7 hours (TNF-alpha) or just before the start of anoxia (A/R + TNF-alpha). Levels of E-selectin, VCAM-1, and ICAM-1 were quantified using specific monoclonal antibodies revealed by an alkaline phosphatase-labeled goat F(ab)'2 fragment against mouse IgG antibody and the fluorescent substrate Attophos. Adhesion experiments were also performed using calcein-labeled U937 leukocytes. HUVECs submitted to A/R overexpressed E-selectin but not VCAM-1 or ICAM-1, whereas TNF-alpha at 0.1 IU/ ml increased the expression of all three adhesion molecules. In endothelial cells subjected to A/R in the presence of TNF-alpha, a synergistic increase of E-selectin expression and a synergistic adhesion of U937 cells was noted. The NADPH oxidase inhibitors apocynin and DPI both decreased significantly the U937 adhesion and the E-selectin overexpression on HUVECs submitted to A/R, TNF-alpha, or A/R + TNF-alpha. These results suggest that E-selectin expression is implicated in the leukocyte adhesion to HUVECs caused by A/R in the presence or absence of an inflammatory context. NADPH oxidase appears to participate in the E-selectin overexpression on HUVECs subjected either to A/R and/or TNF-alpha, suggesting a major role of this enzyme in the ischemia/reperfusion syndrome.

Dietary fat and reduced levels of TGFbeta1 act synergistically to promote activation of the vascular endothelium and formation of lipid lesions.

Transforming growth factor-(beta) (TGF(beta)) has a wide range of activities on vascular cells and inflammatory cells, suggesting it may have different functions during various stages of atherogenesis. We report that mice heterozygous for the deletion of the tgfb1 gene (tgfb1(+/-) mice) have reduced levels of TGF(beta)1 in the artery wall until at least 8 weeks of age. On a normal mouse chow diet, the vascular endothelium of tgfb1(+/-) mice is indistinguishable from wild-type littermates, assessed by morphology and intercellular cell adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) expression. In contrast, levels of the smooth muscle isoforms of actin and myosin in medial smooth muscle cells of tgfb1(+/-) mice are significantly reduced. Following feeding a cholesterol-enriched diet for 12 weeks, high levels of ICAM-1 and VCAM-1 were detected in the vascular endothelial cells of tgfb1(+/-) mice, but not wild-type mice. Furthermore, marked deposition of lipid into the artery wall was only observed in the tgfb1(+/-) mice on the cholesterol-enriched diet. These vascular lipid lesions were accompanied by local invasion of macrophages. We conclude that deletion of a single allele of the tgfb1 gene results in a reduced level of TGFbeta1 antigen in the aorta together with reduced smooth muscle cell differentiation, whereas the addition of a high fat dietary challenge is required to activate the vascular endothelium and to promote the formation of fatty streaks resembling early atherosclerosis in humans.

Influence of puberty on endothelial dysfunction and oxidative stress in young patients with type 1 diabetes.

To examine the influence of puberty on endothelial dysfunction and oxidative stress in children and young people with type 1 diabetes. There were 51 young patients with type 1 diabetes, including 12 prepubertal children, 16 adolescents, and 23 young adults who had no clinical diabetic angiopathy, studied; none had microalbuminuria. The three groups were matched for glycemic control, and systolic and diastolic blood pressures and cholesterol levels were not significantly different between the groups. Endothelium-dependent vasodilatation was assessed by laser Doppler flowmetry after iontophoresis of acetylcholine (ACh) to the skin of the dorsum of the right foot. Soluble E-selectin, intercellular cell adhesion molecule-1 (ICAM-1), von Willebrand factor (vWF), plasma thiol (PSH), red cell glutathione (GSH), and red cell superoxide dismutase (SOD) were measured in blood samples obtained in the early morning. Skin vascular responses to ACh were significantly reduced in the young adult group compared with the prepubertal group (P < 0.05, analysis of variance). The levels of soluble ICAM-1 and E-selectin were significantly higher in the adolescent group compared with the young adult group: 338 (267-415) and 89 (64-106) ng/ml (median [interquartile range]), respectively, versus 255 (222-284) and 58 (54-71) ng/ml (P < 0.01 and P < 0.005, Mann-Whitney U test). SOD levels were significantly higher in the prepubertal group at 250 (238-282) micro/ml, when compared with the adolescent, 217 (171-249) micro/ml (P < 0.04), and young adult, 217 (157-244) micro/ml (P < 0.02), groups. GSH tended to be lower in the adolescent group, 1,192 (1,047-1,367) micromol/l, when compared with the young adults, 1,286 (1,145-1,525) pmol/l, and levels of vWF tended to be higher in the adolescent group, but these failed to reach statistical significance (both P = 0.09). PSH was not different between the three groups. These results suggest that puberty modulates endothelial function and antioxidant mechanisms in childhood diabetes, which may have implications for therapy and intervention.