Prediction of cardiovascular risk using soluble cell adhesion molecules.

Inflammation is now considered a critical pathogenic component of the atherosclerotic process. This is characterized histopathologically by leukocyte infiltration of the vascular endothelial wall. The vascular endothelium is a dynamic organ system, which has natural antiadhesive and anticoagulant properties. However, in response to injury the endothelium promotes coagulation and mediates the binding and transendothelial migration of activated leukocytes. These pathological processes are believed to be critical to the initiation and progression of atherosclerosis as well as the pathogenesis of acute coronary syndromes and are mediated by a group of molecules referred to collectively as cell adhesion molecules. Cell adhesion molecules are a diverse system of proteins and adhesive receptors, which orchestrate vital biological phenomena such as embryogenesis, cell growth and differentiation as well as inflammatory processes. Over the past decade there has been considerable progress in our understanding of adhesion molecules and their complex interactions. Among the many types of adhesion receptors on the cell surface, four main families are described (Fig.1).