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Increased levels of circulating endothelial leukocyte adhesion molecule-1 (ELAM-1) in children with reflux
1Children's Research Centre, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.
Objectives:
The aim of this study was to determine circulating levels of ELAM-1 in sera collected from patients with vesicoureteral reflux, and to investigate the relationship between circulating concentrations of ELAM-1 and reflux nephropathy.
Methods:
The serum levels of ELAM-1 were measured in 117 patients aged between 3 months and 13 years, with grade III to grade V vesicoureteral reflux, and 22 controls, by ELISA technique. Renal scarring was demonstrated in 46 of the 117 children on radionuclide scans.
Results:
The mean serum ELAM-1 levels were 54.23 +/- 20.11 ng/ml in controls and 77.79 +/- 34.50 ng/ml in children with vesicoureteral reflux (p < 0.05). The mean serum ELAM-1 levels in children with vesicoureteral reflux and renal scarring (104.48 +/- 34.53 ng/ml) were significantly higher than in children with VUR without renal scarring (60.51 +/- 20.85 ng/ml; p < 0.001).
Conclusion:
These findings suggest that circulating ELAM-1 levels reflect increased tissue damage in children with vesicoureteral reflux, probably as a result of progressive localised inflammatory responses occurring in these patients.