title: Circulating ICAM-1 is increased in septic shock.
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)
authors.affiliation: Department of Internal Medicine, Medical College of Virginia-Virginia Commonwealth University, Richmond, USA.
authors.forename: C N
authors.initials: CN
authors.lastname: Sessler
authors.forename: A C
authors.initials: AC
authors.lastname: Windsor
authors.forename: M
authors.initials: M
authors.lastname: Schwartz
authors.forename: L
authors.initials: L
authors.lastname: Watson
authors.forename: B J
authors.initials: BJ
authors.lastname: Fisher
authors.forename: H J
authors.initials: HJ
authors.lastname: Sugerman
authors.forename: A A
authors.initials: AA
authors.lastname: Fowler
mesh_terms: D000328:Adult; D000368:Aged; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood; D011379:Prognosis; D012772:Shock, Septic / Q000097:blood*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood
chemical_list: D018799:Intercellular Adhesion Molecule-1