Serum and cerebrospinal fluid levels of soluble intercellular adhesion molecule 1 (sICAM-1) in patients with HIV-1 associated neurological diseases.
We measured levels of soluble intercellular adhesion molecule 1 (sICAM-1) in paired serum and CSF samples of 110 HIV-1-positive patients with and without neurological symptoms and 40 HIV-negative non-immune neurological controls, and in sera of 26 asymptomatic HIV-1-positive patients. Serum sICAM-1 levels in asymptomatic HIV-1-positive patients were significantly increased in comparison to HIV-negative controls. Moreover, they were significantly higher in HIV-1-positive patients with AIDS-defining diseases than in the asymptomatic HIV-1-positive group. In subgroups of patients with neurological disease, the highest serum values were found in HIV encephalopathy. CSF levels of sICAM-1 were elevated only in HIV-1-positive patients with neurological disease mainly due to passive diffusion through a defective blood-brain barrier. An sICAM-1 index was calculated as a measure for intrathecal production of sICAM-1 but showed no significant differences between patients with and without neurological involvement. However, increased levels of the sICAM-1 index were found in some patients with opportunistic CNS infection of bacterial or fungal origin. Serum and CSF levels of sICAM-1 correlated with neopterin levels, a marker of interferon-gamma-mediated macrophage activation and CSF sICAM-1 levels were inversely correlated to numbers of CD4+ T cells. Elevated serum sICAM-1 levels already in asymptomatic HIV-1-positive individuals add to the evidence for an early immune activation in HIV infection. With the further increase of serum and CSF s-ICAM-1 in patients with AIDS-defining diseases sICAM-1 could serve as a new surrogate marker similar to neopterin.
Heidenreich
F
F
Department of Neurology, Heinrich-Heine Universität, Düsseldorf, Germany.
Arendt
G
G
Jander
S
S
Jablonowski
H
H
Stoll
G
G
D015526:AIDS Dementia Complex / Q000097:blood / Q000134:cerebrospinal fluid; D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000134:cerebrospinal fluid; D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications*; D015703:Antigens, CD / Q000097:blood / Q000134:cerebrospinal fluid; D015815:Cell Adhesion Molecules / Q000097:blood* / Q000134:cerebrospinal fluid*; D006801:Humans; D018799:Intercellular Adhesion Molecule-1; D009422:Nervous System Diseases / Q000209:etiology* / Q000378:metabolism*; D012995:Solubility
D015703:Antigens, CD; D015815:Cell Adhesion Molecules; D018799:Intercellular Adhesion Molecule-1