title: Serum adhesion molecule levels as prognostic markers in patients with early systemic sclerosis: a multicentre, prospective, observational study.
abstract: OBJECTIVE
  To assess the utility of circulating adhesion molecule levels as a prognostic indicator of disease progression in systemic sclerosis (SSc) patients with early onset disease.
  
  
  METHODS
  Ninety-two Japanese patients with early onset SSc presenting with diffuse skin sclerosis and/or interstitial lung disease were registered in a multicentre, observational study. Concentrations of intercellular adhesion molecule (ICAM) -1, E-selectin, L-selectin, and P-selectin in serum samples from all patients were measured by enzyme-linked immunosorbent asssay (ELISA). In 39 patients, adhesion molecule levels were measured each year for four years. The ability of baseline adhesion molecule levels to predict subsequent progression and severity in clinical and laboratory features were evaluated statistically.
  
  
  RESULTS
  At their first visit, serum levels of ICAM-1, E-selection, P-selectin were significantly elevated and serum L-selectin levels were significantly reduced in patients with SSc compared with healthy controls. Overall, serum ICAM-1 levels at each time point were significantly inversely associated with the %vital capacity (VC) of the same time and subsequent years by univariate analysis. The initial serum ICAM-1 levels were significantly inversely associated with the %VC at the fourth year by multiple regression analysis. The initial serum P-selectin levels were significantly associated with the health assessment questionnaire disability index (HAQ-DI) at the fourth year by multiple regression analysis. Initial adhesion molecule levels were not significantly associated with other clinical features including skin thickness score. Baseline adhesion molecule levels were not significantly associated with subsequent rate of change of clinical parameters.
  
  
  CONCLUSIONS
  In patients with SSc, serum levels of ICAM-1 and P-selectin may serve as prognostic indicators of respiratory dysfunction and physical disability, respectively. Further longitudinal studies of larger populations are needed to confirm these findings.
authors: Department of Dermatology, School of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan ; Department of Dermatology, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan.
authors: Minoru
authors: M
authors: Hasegawa
authors: Department of Dermatology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors: Yoshihide
authors: Y
authors: Asano
authors: Department of Internal Medicine (Omori), Toho University School of Medicine, Ota-ku, Tokyo, Japan.
authors: Hirahito
authors: H
authors: Endo
authors: Department of Dermatology, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan ; Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors: Manabu
authors: M
authors: Fujimoto
authors: Department of Rheumatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors: Daisuke
authors: D
authors: Goto
authors: Department of Dermatology and Plastic Surgery, School of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan.
authors: Hironobu
authors: H
authors: Ihn
authors: Division of Rehabilitation Science, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan.
authors: Katsumi
authors: K
authors: Inoue
authors: Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors: Osamu
authors: O
authors: Ishikawa
authors: Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
authors: Yasushi
authors: Y
authors: Kawaguchi
authors: Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Masataka
authors: M
authors: Kuwana
authors: Department of Dermatology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Nagasaki, Japan.
authors: Fumihide
authors: F
authors: Ogawa
authors: Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
authors: Hiroki
authors: H
authors: Takahashi
authors: Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors: Sumiaki
authors: S
authors: Tanaka
authors: Department of Dermatology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors: Shinichi
authors: S
authors: Sato
authors: Department of Dermatology, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan.
authors: Kazuhiko
authors: K
authors: Takehara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D018450:Disease Progression; D019040:E-Selectin / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D019041:L-Selectin / Q000097:blood; D008137:Longitudinal Studies; D017563:Lung Diseases, Interstitial / Q000097:blood; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012595:Scleroderma, Systemic / Q000097:blood* / Q000473:pathology; D019087:Selectins / Q000097:blood*; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019040:E-Selectin; D019007:P-Selectin; D019087:Selectins; D018799:Intercellular Adhesion Molecule-1; D019041:L-Selectin