Correlation between circulating soluble ICAM-1 and prednisolone-induced amelioration of ulcerative colitis.
BACKGROUND
A soluble form of intercellular adhesion molecule-1 (sICAM-1) shed from endothelial cells is present in the circulation. Whether the circulating molecules represent passive turnover of surface ICAM-1 or may have some active functions in the inflammatory process is unknown. Glucocorticoids (e.g. prednisolone) are cornerstones in the treatment of acute exacerbations of ulcerative colitis (UC), and influence of the leucocyte/endothelial interaction appears to be part of their mode of action. The aim of the present study was therefore to evaluate the ICAM-1-shedding through measurements of sICAM-1 concentrations during prednisolone treatment of UC patients.


METHODS
Prednisolone (40 mg) was prescribed to 15 patients with severe disease activity. At inclusion, and after 2 weeks of treatment, plasma sICAM-1 levels were measured using the ELISA technique.


RESULTS
The concentrations of sICAM-1 were significantly decreased during treatment from median 256.2 (ng/ml) (interquartile range 239.7-321.0 ng/ml) to 220.4 ng/ml (196.0-276.3 ng/ml) (P < 0.01). This reduction correlated with a decrease in disease activity (r(s) = 0.8; P < 0.003).


CONCLUSIONS
sICAM-1 seems to be a poor diagnostic tool, but since plasma sICAM-1 concentrations decreased during the treatment period, it might prove to be applicable as an activity marker in the individual patient.
Dept. of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark. vainer@rh.dk
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Vainer
O Haagen
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Nielsen
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D003093:Colitis, Ulcerative / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood* / Q000187:drug effects*; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D012720:Severity of Illness Index; D012995:Solubility; D013223:Statistics as Topic; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D005938:Glucocorticoids; D018799:Intercellular Adhesion Molecule-1; D019804:Mesalamine; D011239:Prednisolone