Related Experiment Videos
Circulating ICAM-1 is increased in septic shock
C N Sessler1, A C Windsor, M Schwartz
1Department of Internal Medicine, Medical College of Virginia-Virginia Commonwealth University, Richmond, USA.
Insights
Circulating intercellular adhesion molecule-1 (cICAM-1) is elevated in sepsis patients and correlates with shock severity. This marker may indicate endothelial activation in critical illness, impacting patient outcomes.
Area of Science:
- Immunology
- Critical Care Medicine
- Biomarker Research
Background:
- Adhesion molecules mediate neutrophil-endothelial interactions during inflammation.
- Soluble intercellular adhesion molecule-1 (cICAM-1) is elevated in inflammatory states.
Purpose of the Study:
- Measure cICAM-1 levels in septic adults.
- Assess the relationship between cICAM-1 and sepsis outcomes like organ failure and death.
Main Methods:
- Sandwich-type enzyme-linked immunosorbent assay (ELISA) used for cICAM-1 measurement.
- Blood samples collected within 12 hours of ICU admission.
- Comparison between septic patients, healthy volunteers, and non-septic ICU patients.
Main Results:
- Septic patients showed significantly higher cICAM-1 levels than healthy volunteers (1,259 vs. 355 ng/ml).
- Elevated cICAM-1 was also observed in patients with Systemic Inflammatory Response Syndrome (SIRS) without infection.
- Day 1 cICAM-1 levels positively correlated with septic shock severity (hypotension, vasopressor use).
Conclusions:
- cICAM-1 is a potential marker of endothelial activation in sepsis.
- Elevated cICAM-1 levels are associated with increased sepsis severity and shock.
- Further research may explore cICAM-1's role in predicting sepsis complications.
Abstract:
Adhesion molecules play a critical role in the interaction of circulating neutrophils with vascular endothelium during inflammation. Increased quantities of soluble, circulating intercellular adhesion molecule-1 (cICAM-1) are present in various inflammatory conditions. The purpose of this investigation was to measure cICAM-1 levels in septic adults, as well as to examine the relationship between this potential marker of endothelial-cell activation and the consequences of sepsis (i.e., multiple organ failure and death). Using a sandwich-type enzyme-linked immunosorbent assay (ELISA), we measured cICAM-1 in blood samples obtained within 12 h of admission to an intensive care unit (ICU) for sepsis and other conditions. We found cICAM-1 levels to be increased in 25 septic patients (1,259 +/- 159 ng/ml, mean +/- SEM) as compared with 12 healthy volunteers (355 +/- 41 ng/ml, p < 0.0001) and four ICU patients without systemic inflammatory response syndrome (SIRS) (585 +/- 76 ng/ml, p < 0.001). Twenty-five patients with SIRS but no evidence of causative infection also had elevated levels of cICAM-1 (937 +/- 144 ng/ml, p = 0.12 versus sepsis). Serial measurements over the first week of sepsis demonstrated persistent elevation in most patients. Day 1 cICAM-1 levels were higher (p = 0.017, ANOVA) in 16 patients with septic shock than in seven with severe sepsis and two with sepsis but without hypotension or hypoperfusion. There was a positive correlation (r = 0.50, p = 0.009) between Day-1 cICAM-1 measurements and severity of shock as determined by the presence of hypotension and vasopressor use.(ABSTRACT TRUNCATED AT 250 WORDS)