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Adhesion molecules (E-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1
B Söderquist1, K G Sundqvist, T Vikerfors
1Department of Infectious Diseases, Orebro Medical Centre Hospital, Orebro, Sweden. bo.soderquist@eorebroll.se
Insights
Patients with endocarditis show higher levels of endothelial activation markers E-selectin and VCAM-1 compared to those with Staphylococcus aureus bacteremia alone. This suggests increased endothelial cell involvement in endocarditis.
Area of Science:
- Biomedical research
- Infectious diseases
- Cardiovascular medicine
Background:
- Endothelial activation plays a role in various inflammatory conditions.
- Staphylococcus aureus bacteremia can lead to serious infections, including endocarditis.
- Assessing endothelial activation may help differentiate between bacteremia and endocarditis.
Purpose of the Study:
- To compare endothelial activation in patients with endocarditis versus those with Staphylococcus aureus bacteremia without endocarditis.
- To investigate specific markers of endothelial activation, including E-selectin, ICAM-1, and VCAM-1.
- To explore the relationship between tumor necrosis factor-alpha (TNF-alpha) and endothelial activation markers.
Main Methods:
- Prospective study design.
- Inclusion of 65 patients with blood culture-verified Staphylococcus aureus bacteremia.
- Serum sample analysis using enzyme immunoassays to measure adhesion molecules and TNF-alpha.
Main Results:
- Elevated serum concentrations of adhesion molecules were prevalent in Staphylococcus aureus bacteremia patients.
- Patients with endocarditis exhibited significantly higher serum E-selectin and VCAM-1 levels compared to non-endocarditis bacteremia patients (P=0.01 and P=0.003, respectively).
- No significant difference in ICAM-1 levels was observed between the groups. Serum TNF-alpha concentrations correlated significantly with E-selectin, ICAM-1, and VCAM-1 levels.
Conclusions:
- Endocarditis patients display more extensive endothelial activation than those with S. aureus bacteremia alone.
- E-selectin and VCAM-1 may serve as potential biomarkers for differentiating endocarditis in S. aureus bacteremia.
- Endothelial activation is linked to inflammatory processes in S. aureus infections.
Abstract:
The aim of this prospective study was to evaluate if patients with endocarditis display a more extensive endothelial activation than those with bacteraemia but without endocarditis. Sixty-five patients with blood culture-verified Staphylococcus aureus bacteraemia were included and serum samples collected on admission were analysed by enzyme immunoassays. Elevated serum concentrations of adhesion molecules were found in most of the patients with S. aureus bacteraemia. Patients with endocarditis (n = 15) showed significantly higher serum E-selectin (median 156 ng/ml) and VCAM-1 (median 1745 ng/ml) concentrations compared with those with S. aureus bacteraemia but without endocarditis (80 ng/ml and 1172 ng/ml, respectively; P = 0.01 and P = 0.003). No significant difference was found between the groups concerning ICAM-1 (median 451 ng/ml versus 522 ng/ml). In addition, serum tumour necrosis factor-alpha (TNF-alpha) concentrations were significantly correlated (P < 0.002) to serum levels of E-selectin, ICAM-1 and VCAM-1.