Soluble adhesion molecules in Behçet's disease.
BACKGROUND
Behçet's disease (BD) may lead to blindness in up to 25% of eyes. Soluble (s)ICAM-1 but not sVCAM-1 is associated with relapse in idiopathic uveoretinitis and is reported to be raised in BD patients. We have investigated the levels of sICAM-1 and sVCAM-1 in Palestinian patients with BD and related them to both ocular and systemic disease activity and to immunosuppressive treatment.


METHODS
A total of 51 patients (43 male, 8 female; mean ages 29.8 & 31.9 yr) were examined at the St John Ophthalmic Hospital during a one year period (135 consultations). Disease activity was determined from history and standard ocular examination. Anterior uveitis, vitritis and retinal vasculitis acted as markers of ocular inflammation. Peripheral venous sICAM-1 and sVCAM-1 levels were determined by standard ELISA. A total of 53 healthy age- and sex-matched clinic staff members acted as controls.


RESULTS
sICAM-1 and sVCAM-1 were both significantly lower in patients on systemic immunosuppression than in those off treatment (p < 0.001). Among patients off systemic treatment, sICAM was higher in the group with active systemic disease but quiet eyes (p = 0.003), but not in those with active ocular disease (p = 0.09), compared to controls. sVCAM was not raised in either group.


CONCLUSIONS
Systemic immunosuppression was associated with reduced sICAM-1 and sVCAM-1, supporting a role for adhesion molecules in the pathogenesis of BD. sICAM-1 levels were raised in association with inflammatory features implicating endothelial activation in active BD. The mean sICAM-1 was higher in active ocular patients than controls.
Department of Ocular Immunology, Rayne Institute, St Thomas' Hospital, London, UK. dverity@rayne.umds.ac.uk
D H
DH
Verity
G R
GR
Wallace
P T
PT
Seed
C A
CA
Kanawati
I
I
Ayesh
J
J
Holland-Gladwish
M R
MR
Stanford
D000293:Adolescent; D000328:Adult; D018912:Arabs; D001528:Behcet Syndrome / Q000097:blood* / Q000188:drug therapy / Q000208:ethnology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012995:Solubility; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
D007166:Immunosuppressive Agents; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1