Soluble Adhesion Molecules in Brain Infarction - Adhesion Molecules - page 464

stroke within 24 hr, though there was no signii cant change in E-selectin levels
(Shyu et al. 1997). Bitsch et al. (1998) repeatedly determined soluble AMs by
ELISA in 38 patients over a period of 14 d at er acute cerebral ischemia. In patients
with completed stroke (n = 26), sICAM-1 peaked within 24 hr and sVCAM-1
reached a maximum at er 5 d but not in patients with transient ischemic attack
(n = 12) (Fig. 1) . In a clinical trial, anti-ICAM-1 therapy (enlimomab) was not
ef ective in human ischemic stroke (Enlimomab Acute Stroke Trial Investigators
2001) (Table 1) . Although there are various possible reasons for the failure of
enlimomab, ICAM-1 blockade may have caused the upregulation of other AMs or
the activation of complement-mediated inl ammation. While anti-ICAM-1 therapy
targeting leukocytes has not advanced since this study, i ndings of various studies
investigating the role of AMs in acute ischemic stroke were as follows. Castellanos
et al. (2002) showed that high concentrations of ICAM-1 and TNF-α in blood were
associated with early neurological deterioration and poor functional outcome in
lacunar infarctions. Further, Wang et al. (2006) also reported that elevated serum
ICAM-1 levels on admission were associated with neurological deterioration
in ischemic stroke. Another study that investigated an association between
changes in brachial l ow-mediated vasodilation and ischemic stroke subtypes

(a) (b)

450 450

TIA

completed stroke

400

400

350 350

300 300

250 250

200 200

0 123456 10 14 0 1 2 3 4 5

days after symptom onset days after symptom onset

a)

(c) (d)

1200

1200

1100 1100

1000

1000

TIA

900 900

800 800

700

700

completed stroke

600 600

500 500

0 123456 10 14

0 1 2 3 4 5

days after symptom onset days after symptom onset

Fig. 1 Proi les of soluble adhesion molecule levels at er completed stroke and TIA. Fluctuations
in transient ischemic at ack (TIA) patients were not statistically signii cant. Values are mean ± SD.
**P < 0.05, corrected for multiple comparisons. (Adapted from Bitsch et al . 1998.)