Different time course of circulating adhesion molecules and hyaluran during hepatic allograft rejection.
BACKGROUND
Inducible adhesion molecules are involved in cell-mediated allograft rejection. In addition, the endothelium is the main target of this process. This study investigated, whether soluble (s) forms of vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) are elevated during cellular rejection and whether hyaluran is a useful marker of endothelial function in liver transplantation.


METHODS
Serum levels of sICAM-1, sVCAM-1, and hyaluran were determined in 24 controls and 27 hepatic transplant recipients. These patients were divided in two groups: group I, 14 patients without rejection; and group II, 13 patients with rejection. Samples were collected on day 1 and 7 after transplantation, on the day of liver biopsy, and after treatment of the rejection.


RESULTS
We found a significant increase in sICAM-1 levels in the postoperative period in the rejection group compared with the non rejection group. It persisted significantly elevated until the diagnosis of rejection was made. In contrast, sVCAM-1 was only significantly elevated in the rejection group when diagnosis of rejection was evident. Hyaluran levels were also significantly elevated in the rejection group at diagnosis of rejection. We noticed a significant decline in sICAM-1, sVCAM-1, and hyaluran levels after successful treatment of rejection. In addition, we observed in the non-rejection group a stable lower levels of hyaluran during the entire postoperative period.


CONCLUSIONS
The release of circulating adhesion molecules is a prominent feature coinciding with the first episode of hepatic rejection. Differential patterns of sICAM-1 and sVCAM-1 exist during rejection. In addition, hyaluran levels may be a sensitive marker of liver endothelial cell function in the postoperative period of liver transplantation.
Fábrega
E
E
Department of Surgery, Faculty of Medicine, University Hospital Marqués de Valdecilla, Santander, Spain.
Castro
B
B
Crespo
J
J
de la Peña
J
J
Gómez-Fleitas
M
M
García-Unzueta
M T
MT
Amado
J A
JA
Pons-Romero
F
F
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004730:Endothelium, Vascular / Q000166:cytology; D005260:Female; D006084:Graft Rejection / Q000097:blood*; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D016031:Liver Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012995:Solubility; D013997:Time Factors; D014184:Transplantation, Homologous / Q000502:physiology; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
D015415:Biomarkers; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D006820:Hyaluronic Acid