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Endothelial cell adhesion molecules in meningococcal disease
P B Baines1, O Marzouk, A P Thomson
1Intensive Care Unit, Royal Liverpool Children's Hospital, UK. p.baines@liverpool.ac.uk
Archives of Disease in Childhood
|May 18, 1999
Summary
Shed intercellular cell adhesion molecule 1 (ICAM-1) and E selectin levels indicate endothelial activation in meningococcal disease. Higher E selectin concentrations correlate with severe disease, while P selectin levels may predict mortality.
Area of Science:
- Pediatric Infectious Diseases
- Vascular Biology
- Immunology
Background:
- Endothelial damage plays a crucial role in the pathogenesis of meningococcal disease.
- Activated endothelium expresses cell adhesion molecules like P selectin, E selectin, and ICAM-1, which are subsequently shed into circulation.
Purpose of the Study:
- To investigate the levels of shed cell adhesion molecules (P selectin, E selectin, ICAM-1) in children with meningococcal infections.
- To determine if these molecules correlate with disease severity and outcome.
Main Methods:
- Measurement of ICAM-1, P selectin, and E selectin concentrations in children upon hospital admission.
- Classification of meningococcal disease severity using the Glasgow meningococcal septicaemia prognostic score (GMSPS).
Main Results:
- Elevated E selectin and ICAM-1 levels were observed in children with meningococcal disease compared to controls.
- Significantly higher E selectin concentrations were found in severe meningococcal disease cases (GMSPS ≥ 8) versus mild cases (GMSPS < 8).
- P selectin concentrations were not significantly altered in meningococcal disease, but lower levels were associated with mortality.
Conclusions:
- Shed concentrations of ICAM-1 and E selectin serve as reliable indicators of endothelial activation in meningococcal disease.
- These markers may aid in assessing disease severity and potentially predicting outcomes in pediatric meningococcal infections.