title: Circulating soluble adhesion molecules in patients with classical polyarteritis nodosa.
abstract: The objective was to evaluate whether changes in circulating soluble adhesion molecule levels reflect disease activity in patients with systemic polyarteritis nodosa (PAN). A sandwich ELISA was used to measure soluble (s) intercellular adhesion molecule 1 (sICAM-1), vascular cell adhesion molecule 1 (sVCAM-1), E-selectin, L-selectin and P-selectin in sera and plasma from 22 patients with active PAN, in sera from 13 of these patients taken serially during follow-up, and in sera from 13 healthy controls. At the time of diagnosis, sICAM-1, sVCAM-1 and sE-selectin levels (488.5 +/- 201.3, 1176.5 +/- 514.1 and 60.6 +/- 27 ng/ml, respectively) were significantly higher in patients than in controls (P < 0.0001, P = 0.001 and P = 0.003, respectively). In contrast, sL-selectin levels tended to be lower in patients than in controls. Within the first 7 days after starting treatment, there was a significant increase in sICAM-1 concentrations, which fell thereafter, but did not completely reach normal levels when patients achieved clinical remission. sE-selectin also remained elevated during follow-up. Only sVCAM-1 decreased, tending to reach normal values in inactive disease. Increased levels of sICAM-1, sVCAM-1 and sE-selectin, and decreased levels of sL-selectin, in active PAN suggest immune and endothelial stimulation during disease activity. Abnormal levels of soluble adhesion molecules in clinically inactive patients might reflect persistence of immune activation and/or endothelial cell exposure to a remaining inflammatory microenvironment.
authors.affiliation: Department of Internal Medicine, Hospital Clínic, Barcelona, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Coll-Vinent
authors.forename: J M
authors.initials: JM
authors.lastname: Grau
authors.forename: A
authors.initials: A
authors.lastname: López-Soto
authors.forename: J
authors.initials: J
authors.lastname: Oristrell
authors.forename: C
authors.initials: C
authors.lastname: Font
authors.forename: X
authors.initials: X
authors.lastname: Bosch
authors.forename: E
authors.initials: E
authors.lastname: Mirapeix
authors.forename: A
authors.initials: A
authors.lastname: Urbano-Márquez
authors.forename: M C
authors.initials: MC
authors.lastname: Cid
mesh_terms: D000328:Adult; D000368:Aged; D015815:Cell Adhesion Molecules / Q000097:blood*; D019040:E-Selectin / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D019041:L-Selectin / Q000097:blood; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D010488:Polyarteritis Nodosa / Q000097:blood* / Q000188:drug therapy; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
chemical_list: D015815:Cell Adhesion Molecules; D019040:E-Selectin; D007166:Immunosuppressive Agents; D019007:P-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D019041:L-Selectin