1. Vascular inflammation in cerebral small vessel disease
- Author
-
Rob P.W. Rouhl, Peter W. de Leeuw, Julie Staals, Abraham A. Kroon, Iris L.H. Knottnerus, Léon H.G. Henskens, Jan Damoiseaux, Jan Lodder, Jan Willem Cohen Tervaert, Ruud Theunissen, Robert J. van Oostenbrugge, Family Medicine, RS: CARIM School for Cardiovascular Diseases, RS: MHeNs School for Mental Health and Neuroscience, MUMC+: MA Med Staf Spec Neurologie (9), Klinische Neurowetenschappen, and Interne Geneeskunde
- Subjects
Adult ,Male ,Vasculitis ,Aging ,Pathology ,medicine.medical_specialty ,Lacunar stroke ,Adolescent ,Neuroscience(all) ,Clinical Neurology ,Cerebral small vessel disease ,Blood–brain barrier ,Neopterin ,White matter lesions ,Endothelial activation ,chemistry.chemical_compound ,Lacunar infarcts ,Young Adult ,Medicine ,Macrophage ,Humans ,Aged ,Aged, 80 and over ,business.industry ,Cell adhesion molecule ,General Neuroscience ,Monocyte ,Macrophage Activation ,Middle Aged ,medicine.disease ,Hyperintensity ,Ageing ,medicine.anatomical_structure ,chemistry ,Cerebral Small Vessel Diseases ,Immunology ,Microvessels ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,Adhesion molecules ,Cell Adhesion Molecules ,Developmental Biology - Abstract
Cerebral small vessel disease (CSVD) is considered to be caused by an increased permeability of the blood-brain barrier and results in enlargement of Virchow Robin spaces (VRs), white matter lesions, brain microbleeds, and lacunar infarcts. The increased permeability of the blood-brain barrier may relate to endothelial cell activation and activated monocytes/macrophages. Therefore, we hypothesized that plasma markers of endothelial activation (adhesion molecules) and monocyte/macrophage activation (neopterin) relate to CSVD manifestations. In 163 first-ever lacunar stroke patients and 183 essential hypertensive patients, we assessed CSVD manifestations on brain magnetic resonance imaging (MRI) and levels of C-reactive protein (CRP), neopterin, as well as circulating soluble adhesion molecules (sICAM-1, sVCAM-1, sE-selectin, sP-selectin). Neopterin, sICAM-1 and sVCAM-1 levels were higher in patients with extensive CSVD manifestations than in those without (p < 0.01). Neopterin levels independently related to higher numbers of enlarged Virchow Robin spaces (p < 0.001). An inflammatory process with activated monocytes/macrophages may play a role in the increased permeability of the blood brain barrier in patients with CSVD.
- Published
- 2010