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Increased plasma concentrations of circulating intercellular adhesion molecule-1 (cICAM-1) in patients with
P Kaufmann1, G P Tilz, K H Smolle
1Department of Internal Medicine, Karl Franzens University, Graz, Austria.
Insights
Elevated levels of circulating intercellular adhesion molecule-1 (cICAM-1) indicate acute pancreatitis, particularly severe necrotizing pancreatitis. This marker shows potential for predicting pancreatitis severity and associated tissue damage.
Area of Science:
- Biochemistry
- Immunology
- Gastroenterology
Background:
- Intercellular adhesion molecule-1 (ICAM-1) is crucial for leukocyte adhesion and migration.
- Circulating ICAM-1 (cICAM-1) is elevated in inflammatory conditions.
- Acute pancreatitis involves inflammation and potential tissue damage.
Purpose of the Study:
- To determine if cICAM-1 levels are elevated in acute pancreatitis patients within 48 hours of symptom onset.
- To investigate the correlation between cICAM-1 levels and the severity of pancreatic tissue damage.
Main Methods:
- Measured plasma cICAM-1 concentrations in 25 acute pancreatitis patients and 18 healthy controls.
- Utilized contrast-enhanced CT or laparotomy to classify pancreatitis severity (edematous vs. necrotizing).
- Assessed correlation between cICAM-1 and C-reactive protein (CRP).
Main Results:
- Patients with acute pancreatitis had significantly higher cICAM-1 levels (548 ng/ml) than controls (343 ng/ml).
- Acute necrotizing pancreatitis showed markedly elevated cICAM-1 (729 ng/ml) compared to mild pancreatitis (367 ng/ml) and controls.
- cICAM-1 levels correlated significantly with CRP (r=0.62, p<0.01).
- cICAM-1 demonstrated 75% sensitivity and 85% specificity for detecting edematous or necrotizing pancreatitis at a 500 ng/ml cutoff.
Conclusions:
- Enhanced release of cICAM-1 occurs in early acute necrotizing pancreatitis.
- Leukocyte-endothelial cell adhesion may contribute to necrotizing tissue damage in pancreatitis.
- cICAM-1 shows potential as an early marker or predictor of severe pancreatitis.
Abstract:
The intercellular adhesion molecule-1 (ICAM-1), a membrane glycoprotein, is important in the adhesion of cytokine-stimulated leukocytes to the endothelium of microvessels and their transendothelial migration. Circulating isoforms of ICAM-1 (cICAM-1) are known to be elevated in human serum as an indirect consequence of inflammatory responses. The aim of this study was to investigate whether cICAM-1 levels are elevated in patients with acute pancreatitis within 48 h of the onset of abdominal pain and whether cICAM-1 levels correlate with the severity of the tissue damage. Twenty-five consecutive patients admitted to a medical ICU had elevated cCAM-1 concentrations of 548 +/- 68 ng/ml, significantly different when compared to a control group of 18 healthy subjects (343 +/- 29; p = 0.018). According to the findings of contrast-enhanced CT or laparotomy patients were further divided in a group with acute edematous pancreatitis and a group with acute necrotizing pancreatitis. Pancreatic necrosis was associated with cICAM-1 levels of 729 +/- 106 ng/ml, significantly different from patients with mild disease (367 +/- 48) and controls (p < 0.001). Plasma cICAM-1 levels were not significantly different between healthy subjects and patients with mild pancreatitis. A significant correlation was found between cICAM-1 and C-reactive protein, an acute phase reactant and marker of necrotizing pancreatitis (r = 0.62; p < 0.01). The sensitivity and specificity for the detection of edematous or necrotizing pancreatitis of cICAM-1 plasma concentrations (cutoff point at 500 ng/ml) were 75% and 85%, respectively. These results suggest an enhanced release of ICAM-1 into plasma in the early stage of acute necrotizing pancreatitis. Leukocyte-endothelial cell adhesion may be associated with the inflammatory process of necrotizing tissue damage in acute pancreatitis. It could thus serve as a marker or predictor of a severe clinical course of pancreatitis.
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