Elevated levels of circulating adhesion molecules in patients with active pulmonary tuberculosis.
OBJECTIVE
Recent studies have indicated the importance of cell adhesion molecules in the pathogenesis of various inflammatory lung diseases. Our study was designed to determine whether five soluble adhesion molecules including soluble L-, E- and P-selectin (sL-, sE- and sP-selectin), intercellular adhesion molecule-1 (sICAM-1), and vascular cell adhesion molecule-1 (sVCAM-1) in serum reflect the severity of active pulmonary tuberculosis (TB), and whether there is a distinct profile of these soluble molecules in this disease.


METHODS
Using enzyme-linked immunosorbent assays, we measured the serum levels of these five soluble adhesion molecules in 31 patients with active TB and 11 healthy volunteers.


RESULTS
Serum levels of sE-selectin, sP-selectin and sICAM-1, but not sL-selectin or sVCAM-1, were significantly higher in patients with active TB than in the control subjects (P < 0.001, each). Significant correlations were detected only between serum levels of sE-selectin and sP-selectin, sE-selectin and sICAM-1, and sP-selectin and sICAM-1. There was a significant correlation between the Gaffky scale result (a scale assessing the number of mycobacteria bacilli present) and all of the above adhesion molecules, except for sL-selectin. Serum levels of sE-selectin, sL-selectin and sICAM-1 also correlated with the CXR radiological score. Higher levels of sL-selectin and sICAM-1 were detected in the serum of patients with radiological cavity formation compared to those without. The ESR, C-reactive protein and circulating neutrophil counts all correlated significantly with sE-selectin, sP-selectin, sICAM-1 and sVCAM-1.


CONCLUSIONS
The results suggest that there is a distinct profile of soluble adhesion molecules in active pulmonary TB and that sE-selectin, sP-selectin, and especially sICAM-1 appear to be the most sensitive clinical measures of disease severity.
Mukae
Hiroshi
H
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan. hmukae@net.nagasaki-u.ac.jp
Ashitani
Jun-ichi
J
Tokojima
Masatoshi
M
Ihi
Toshihiko
T
Kohno
Shigeru
S
Matsukura
Shigeru
S
D000328:Adult; D000368:Aged; D015815:Cell Adhesion Molecules / Q000097:blood*; D005260:Female; D006801:Humans; D007118:Immunoassay; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014397:Tuberculosis, Pulmonary / Q000097:blood* / Q000145:classification
D015815:Cell Adhesion Molecules