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Serum circulating ICAM-1 levels are not useful to indicate active vasculitis or early renal allograft rejection
S John1, H H Neumayer, M Weber
1Medizinische Klinik IV mit Poliklinik, Universität Erlangen-Nürnberg, Germany.
Insights
Serum levels of soluble intercellular adhesion molecule-1 (c-ICAM-1) may not reliably indicate disease activity in vasculitis or aid in early diagnosis of kidney transplant rejection. Further research is needed to establish c-ICAM-1
Area of Science:
- Immunology
- Nephrology
- Rheumatology
Background:
- Activated endothelial cells express adhesion molecules during inflammation.
- Circulating intercellular adhesion molecule-1 (c-ICAM-1) serum levels are proposed indicators of endothelial activation.
- The utility of c-ICAM-1 for assessing vasculitis activity and transplant rejection is under investigation.
Purpose of the Study:
- To evaluate the usefulness of c-ICAM-1 serum levels in assessing disease activity in vasculitic disorders.
- To determine if c-ICAM-1 can aid in the early diagnosis of acute allograft rejection after kidney transplantation.
Main Methods:
- Measured serum c-ICAM-1 concentrations in patients with active vasculitis (SLE, WG, GP, MP) and in clinical remission.
- Assessed c-ICAM-1 levels in kidney transplant recipients post-transplantation, during rejection, and after successful therapy.
- Compared patient levels to those of healthy volunteers.
Main Results:
- Patients with active vasculitis showed elevated mean c-ICAM-1 levels compared to healthy controls.
- However, c-ICAM-1 levels in patients with vasculitis did not consistently decrease upon achieving clinical remission.
- Data on c-ICAM-1 in kidney transplant rejection was truncated in the abstract.
Conclusions:
- Serum c-ICAM-1 levels may not be a reliable marker for disease activity in vasculitis.
- The role of c-ICAM-1 in diagnosing kidney transplant rejection requires further investigation.
- Current findings suggest limited utility of c-ICAM-1 as a sole diagnostic or monitoring tool in these conditions.
Abstract:
During inflammation, activated vascular endothelial cells and other cell types express various adhesion molecules which facilitate binding of circulating leukocytes. Serum concentration of circulating adhesion molecule ICAM-1 (c-ICAM-1) is supposed to reflect the degree of this activation. In order to evaluate the usefulness of c-ICAM-1 serum levels for assessment of disease activity in various vasculitic disorders, we examined 23 patients with systemic lupus erythematosus (SLE, n = 9). Wegener's granulomatosis (WG, n = 6), Goodpasture syndrome (GP, n = 6) and microscopic polyarteritis (MP, n = 2). Disease activity was defined by clinical criteria and by conventional laboratory data. Circulating ICAM-1 concentrations were measured during periods of active clinical vasculitis and on clinical remission. In a second part of the study, we examined whether or not c-ICAM-1 might be helpful in diagnosing acute allograft rejection early after kidney transplantation. After cadaveric kidney transplantation thirteen patients were included. Serum probes were gathered firstly after transplantation, secondly at time of histologically proven allograft rejection and finally after successful anti-rejection therapy and restored transplant function. c-ICAM-1 levels in healthy volunteers (n = 10) were 270 +/- 47 ng/ml (mean +/- SD). Patients with active vasculitis had mean serum levels of 509 +/- 71 ng/ml (SLE), 594 +/- 118 ng/ml (WG), 472 +/- 126 ng/ml (GP) and 498 ng/ml (MP) (mean +/- SD). In clinical remission, mean serum concentrations were found to be 500 +/- 99 ng/ml (SLE), 597 +/- 84 ng/ml (WG), 782 +/- 163 ng/ml (GP) and 594 ng/ml (MP) (mean +/- SD).(ABSTRACT TRUNCATED AT 250 WORDS)