Even moderate cigarette smoking influences the pattern of circulating monocytes and the concentration of sICAM-1
Introduction
In women, the cardiovascular risk increases dramatically after menopause. Menopause as a marker for the end of women‘s natural protection against coronary heart disease and aging are among the non-modifiable risk factors of atherosclerosis, while cigarette smoking, overweight or physical inactivity belong to the modifiable cardiovascular risk factors.
Cigarette smoking is a strong independent cardiovascular risk factor, associated with a chronic inflammatory process. In male severe smokers Targher et al. (1996) observed significant higher absolute and relative counts of circulating monocytes. Cigarette smoking may contribute to the development of atherosclerosis increasing the activation of circulating monocytes as well as their aggregation and adhesion to the endothelium. The adhesion of circulating leukocytes (monocytes) to the endothelium and their recruitment into the vessel wall are the earliest detectable events in the formation of atherosclerotic plaques (Fagged et al., 1984). The pool of circulating monocytes consists of different subpopulations which are discriminated by the expression of low (CD16) and high affinity (CD64) Fc receptors, the lipopolysaccharid (LPS) receptor (CD14) and the pan myeloid cell marker (CD33) (Rothe et al., 1996). Systemic abnormalities in the monocyte-macrophage subpopulation pattern may play a role in the atherogenesis (Rothe et al., 1996). The adhesion and the transendothelial migration of the circulating monocytes are mediated by several membrane-bound adhesion molecules of the integrin family. The intercellular adhesion molecule 1 (ICAM-1) represents their endothelial counterpart. ICAM-1 (CD54) is expressed by endothelial cell in response to inflammatory cytokines and binds to the receptors placed on monocytes (CD43),(CD11b). The serum concentration of the soluble ICAM-1 is a good surrogate marker for the cellular expression of this adhesion molecule.
The aim of the present study was to assess whether even moderate cigarette smoking in middle-aged women alters the pattern of circulating monocytes and/or modifies their adhesion to the endothelium.
Section snippets
Design
The subsample of 387 middle-aged women selected for this Public health study 1 were participants of the DRECAN study2. Among them were 33 women who smoked regular during the last 6 years (10 women<10 cigarettes/day, five women 10–20 cigarettes/day). The control
Results
Within normal ranges, the haematological parameters haemoglobin and haematokrit tend to higher values in smokers than in non-smokers. Mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) are significantly higher in smokers. Total leukocyte counts are within the normal range (3.8–9.8 Gpt/l) in both groups, but the mean total leukocyte count is significantly higher in smokers than in non-smokers (Table 2). The percentage distribution of monocytes, neutrophiles and lymphocytes is
Discussion
Cigarette smoking was clearly linked with increased evidence of atherosclerosis and cardiovascular diseases. Cigarette smoking and hypercholesterolaemia as cardiovascular risk factors were associated with impaired endothelial function. The pathogenesis of atherosclerosis was characterized by an increased adhesion of monocytes to the endothelium. Huang et al. (1996) proposed that hypercholesterolaemia in men as well as in women has a strong peripheral monocyte-reducing effect due to direct
Acknowledgements
Authors thank the staff of the heamatological laboratory for their excellent realization of the flow cytometric analyses. This work was supported by a grant (DLR 01EG9410) by the Bundesministerium für Bildung und ForschungPublic Health Forschungsverbund Sachsen A5. Psychosoziale Ressourcen und kardiovaskuläres Risiko bei Frauen im mittleren Lebensalter.
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