Circulating ICAM-1 is increased in septic shock.

Abstract

Adhesion molecules play a critical role in the interaction of circulating neutrophils with vascular endothelium during inflammation. Increased quantities of soluble, circulating intercellular adhesion molecule-1 (cICAM-1) are present in various inflammatory conditions. The purpose of this investigation was to measure cICAM-1 levels in septic adults, as well as to examine the relationship between this potential marker of endothelial-cell activation and the consequences of sepsis (i.e., multiple organ failure and death). Using a sandwich-type enzyme-linked immunosorbent assay (ELISA), we measured cICAM-1 in blood samples obtained within 12 h of admission to an intensive care unit (ICU) for sepsis and other conditions. We found cICAM-1 levels to be increased in 25 septic patients (1,259 +/- 159 ng/ml, mean +/- SEM) as compared with 12 healthy volunteers (355 +/- 41 ng/ml, p < 0.0001) and four ICU patients without systemic inflammatory response syndrome (SIRS) (585 +/- 76 ng/ml, p < 0.001). Twenty-five patients with SIRS but no evidence of causative infection also had elevated levels of cICAM-1 (937 +/- 144 ng/ml, p = 0.12 versus sepsis). Serial measurements over the first week of sepsis demonstrated persistent elevation in most patients. Day 1 cICAM-1 levels were higher (p = 0.017, ANOVA) in 16 patients with septic shock than in seven with severe sepsis and two with sepsis but without hypotension or hypoperfusion. There was a positive correlation (r = 0.50, p = 0.009) between Day-1 cICAM-1 measurements and severity of shock as determined by the presence of hypotension and vasopressor use.(ABSTRACT TRUNCATED AT 250 WORDS)

Adhesion molecules (E-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1)) in sera from patients withStaphylococcus aureusbacteraemia with or without endocarditis

“…The highest serum concentrations of both various cytokines as well as adhesion molecules have been reported in patients with septic shock and fatal outcome [4,7,8]. In the present study nonsurvivors showed higher serum levels of all the three adhesion molecules compared with those who did survive, but the differences did not reach statistical signi®cance.…”

“…It has also been proposed that the release of E-selectin is related to the degree of vascular or endothelial injury caused by the sepsis [4]. Increased plasma and serum levels of VCAM-1 and ICAM-1 have been shown in bacteremic patients [7,8]. E-selectin as well as ICAM-1 has also been found to be associated with multiple organ dysfunction, septic shock and death [7,8].…”

“…Also associations have been found between increased concentrations of adhesion molecules and either multiple organ dysfunction, disease severity or death [4,7,8].…”

Inhibition of Macrophages With Gadolinium Chloride Alters Intercellular Adhesion Molecule–1 Expression in the Liver During Acute Endotoxemia in Rats

“…7-9 Increased quantities of soluble circulating adhesion molecules have also been detected in various models of liver injury. 2,7,8,10 These findings, together with the observation that liver injury is abrogated by administration of antibodies to certain cell adhesion molecules, [4][5][6]11 suggest that they play a role in hepatotoxicity associated with inflammation.Endotoxin is a bacterially derived product known to induce liver injury at toxic doses. 12 We have previously demonstrated that acute endotoxemia is associated with an increase in the number of macrophages in the liver.…”

Microcirculatory dysfunction and tissue oxygenation in critical illness

“…Upon activation, endothelial cells and adhesion molecules are shed. The increased levels of circulating endothelial cells and adhesion molecules in septic patients may therefore reflect factors of importance to parallel changes in the capillary circulation 42, 43, 44, 45, 46…”