RESUMO
Neuroinflammatory mechanisms play an important role in ischemic injury and interruption of these processes can result in improved neurological outcomes. Firm adhesion of leukocytes to the endothelial cells as well as leukocyte activation and transmigration across the endothelium is mediated by adhesion molecules. We aimed to assess the levels of serum soluble vascular cell adhesion molecule-1 [sVCAM-1] in acute stroke and their correlation to the extent of neurological deficits and short term clinical outcome. Forty four patients with first ever acute ischemic stroke admitted within 72 hours of stroke onset were enrolled, in addition to eighteen normal controls and twelve patients with vascular risk factors matched with age and sex to the patients group. Blood samples were obtained from the patients at the third day of stroke onset and from the control groups and subjected to the measurement of the level of sVCAM-1 in the serum. There is a higher mean sVCAM-1 among patients with ischemic stroke compared to normal controls and the difference is highly significant statistically, P<0.01. There is a higher mean sVCAM among patients with large vessel disease compared to patients with small vessel disease and the difference is highly significant statistically, P<0.01. There is a highly significant positive correlation between sVCAM-1 and NIHSS score, P<0.01. Also we found a statistically significant negative correlation between Barthel Index Score and sVCAM-1, P<0.05. The results support the prior hypothesis of involvement of the adhesion molecules [VCAM-1] in the pathogenesis of acute cerebral ischemia and their impact on neuronal damage and neurological deficit. Therapeutic trials that attempt to interfere with the function of adhesion molecules could be of benefit in acute stroke management