The Contribution of the Selected Adhesion Molecules to the Pathogenesis of the Endothelium Injury at the Diabetes and Arterial Hypertension Patients

Abstract

Background In the process of the damage of the vascular endothelium the immunological and inflammatory mechanisms have a crucial role. The damage and circulating in the peripheral blood endothelial cells (EC) have became an objective index, reflecting the degree of the endothelium damage in different pathological states. The adhesion molecules (CAM) from the selectine family have got an essential role in the primary stage of the leukocyte adhesion on endothelium.
Methods We examined 48 diabetes patients (IDDM and NIDDM) - with the normal functionning of the kidneys and without the 3rd and 4th period of the chronic arterial ischaemia, with the illness duration of 1 to 15 years. In each group we selected the patients -with the normal values of arterial blood pressure and with the co-existing hypertension. Both arterial and venous blood was analyzed. The number of circulating endothelial cells (EC) was established using the immunological method after Sbarbati. The soluble adhesion molecules (selectines L, P, E) were estimated with the method ELISA.
Results We did not show any significant differences in the analyzed parametres between the arterial and venous blood. The damage of the endothelium, given as the increase of the number of circulating EC was processing in the signif icant increase of the concentration of the selectines E. The increase of the selectine L was shown with the number of circulating EC > 1 cell/ml, while of the selectine P in all cases. We found an increase of circulating EC with all the diabetes and arterial hypertension patients, and an increase of the selectines L and P in diabetes type 1 with the hypertension in a confrontation with normotension diabetics. No influence of hypertension on the concentration of the selectines P and E was found.
Conclusions The measure of the circulating EC distinguishes significantly two basic types of diabetes, and the dynamics and the degree of the endothelium damage stays significantly dependent from the coexisting arteriar hypertension. The increase of the concentration of the selectine L and in blood is proportional to the degree of the damage of the vascular wall, dominating in diabetes t. 2. In diabetes type 1 the age border about 30 years is the crucial moment, decisive for the progression of the destructive changes in endothelium, dependent on the illness duration. The increase of the selectine E in blood is characteristic for young people with diabetes t.l and it is dependent from the coexisting arteriar hypertension in a small degree only.