Value of ICAM-1 expression and soluble ICAM-1 level as a marker of activity in sarcoidosis.
BACKGROUND
The natural course of sarcoidosis is variable, but no single parameter has been generally accepted as a good marker for disease activity. Adhesion molecules are required for the migration of inflammatory cells; thus, they may be markers of activity in sarcoidosis.


METHODS
In 16 patients with active sarcoidosis and 11 with inactive disease (10 were male, 17 were female; mean age [-/+ SD], 39.6+/-11.0 years; mean follow-up, 21+/-16 months), the expression of adhesion molecules on cells obtained with BAL (measured by flow cytometry) and the level of soluble intercellular adhesion molecule 1 (sICAM-1) in the serum and BAL fluid (BALF) were measured at the time of diagnosis and during the follow-up. The changes in serum sICAM-1 level and ICAM-1 expression on cells obtained with BAL were compared with the clinical course of the disease.


RESULTS
In patients with active disease, the ICAM-1 on alveolar macrophage (AM) (relative linear median fluorescence intensity [RMFI], 3.21+/-1.55) and sICAM-1 levels in serum (575+/-221 ng/mL) and BALF (47.3+/-19.3 ng/mL) were higher than those for patients with inactive disease (RMFI, 1.67+/-0.66; p = 0.0034; serum, 263+/-98.5 ng/mL; p = 0.0001; BALF, 27.5+/-19.0 ng/mL; p = 0.0209). In the patients with active disease, ICAMN-1 on AM and serum sICAM-1 decreased (RMFI, 1.51+/-0.84; 284+/-118 ng/mL, respectively) after steroid therapy, but no significant change was noted in patients with inactive disease. We also found that the initial ICAM-1 on AM and serum sICAM-1 had a significant correlation with the degree of improvement in pulmonary function tests after the therapy. The disease relapsed in four patients after the discontinuation of steroids, and the serum sICAM-1 level was elevated again at the time of relapse.


CONCLUSIONS
Our data suggest that the serum sICAM-1 level and the ICAM-1 expression on AM may be good markers of disease activity and also a predictor of outcome in sarcoidosis.
Kim
D S
DS
Department of Internal Medicine, Asan Medical Center, Ulsan University, Seoul, Korea. dskim@www.amc.seoul.kr
Paik
S H
SH
Lim
C M
CM
Lee
S D
SD
Koh
Y
Y
Kim
W S
WS
Kim
W D
WD
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000032:analysis* / Q000097:blood; D016676:Macrophages, Alveolar / Q000737:chemistry; D008297:Male; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis* / Q000378:metabolism; D012995:Solubility
D015415:Biomarkers; D018799:Intercellular Adhesion Molecule-1