title: Soluble adhesion molecules in juvenile rheumatoid arthritis.
abstract: OBJECTIVE
  To determine serum levels of soluble (s) adhesion molecules in patients with juvenile rheumatoid arthritis (JRA), and to determine whether differences exist in these levels among the 3 subtypes of JRA, and whether levels of these molecules correlate with other measures of disease activity.
  
  
  METHODS
  Serum levels of soluble forms of intercellular adhesion molecule-1 (ICAM-1), ICAM-3, vascular (V) CAM-1, L-selectin, and E-selectin were determined by sandwich ELISA in 16 patients with JRA (6 systemic, 6 polyarticular, 4 pauciarticular). Differences in levels among JRA subtypes were determined by ANOVA, and correlations between levels and the following clinical variables were assessed by linear regression analysis: erythrocyte sedimentation rate (ESR), total white blood cell count (WBC), hematocrit (HCT), platelet count (PLT), and total swollen joint count (JC).
  
  
  RESULTS
  sE-selectin levels were significantly higher in patients with systemic disease compared to other subtypes (p<0.04). Furthermore, there was a trend toward higher levels of sICAM-1 in systemic disease, which did not reach statistical significance. Significant correlations were found between sE-selectin and ESR (r = 0.68, p<0.006), WBC (r = 0.70, p<0.003), and PLT (r = 0.54, p<0.05) and between sL-selectin and WBC (r = 0.55, p<0.03).
  
  
  CONCLUSIONS
  Because of the small number of patients studied, and the lack of age matched control data, our results must be interpreted with caution. Nonetheless, levels of sE-selectin, and possibly ICAM-1 appear to be relatively elevated in systemic JRA, and may indicate cytokine induction and endothelial cell activation in that subtype. Several molecules, especially sE-selectin, correlate with hematologic variables in JRA. These results suggest that serum levels of these molecules may provide a useful additional marker for disease activity in certain patients.
authors.affiliation: Department of Pediatrics, Hasbro Children's Hospital, Providence, RI 02903, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Bloom
authors.forename: L C
authors.initials: LC
authors.lastname: Miller
authors.forename: L B
authors.initials: LB
authors.lastname: Tucker
authors.forename: J G
authors.initials: JG
authors.lastname: Schaller
authors.forename: P R
authors.initials: PR
authors.lastname: Blier
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D015703:Antigens, CD; D000943:Antigens, Differentiation; D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D015415:Biomarkers / Q000032:analysis; D015815:Cell Adhesion Molecules / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D019040:E-Selectin / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D019041:L-Selectin / Q000097:blood*; D008297:Male; D010865:Pilot Projects; D011379:Prognosis; D012680:Sensitivity and Specificity; D012995:Solubility
chemical_list: D015703:Antigens, CD; D000943:Antigens, Differentiation; D015415:Biomarkers; D015815:Cell Adhesion Molecules; D019040:E-Selectin; C483616:ICAM3 protein, human; D018799:Intercellular Adhesion Molecule-1; D019041:L-Selectin