Circulating intercellular adhesion molecule 1 in rheumatoid arthritis — Relationship to systemic vasculitis and microvascular injury in nailfold capillary microscopy

Abstract

Intercellular adhesion molecule-1 (ICAM-1) is a membrane bound molecule that plays an important role in the pathogenic inflammatory responses observed in vasculitis. The aim of this study was to determine whether levels of soluble ICAM-1 sICAM-1) shedding into the circulation reflect the vascular injury found in nailfold capillaroscopy as well as systemic vasculitis in RA patients. We determined serum levels of sICAM-1 and soluble interleukin-2 receptor (sIL-2R) by an enzyme-linked immunosorbent assay in 79 RA patients. Serum levels of sICAM-1 were significantly increased in RA patients compared to 30 healthy controls. RA patients with clinical signs of systemic vasculitis showed significantly higher levels of sICAM-1 than those without vascular involvement. Although no significant correlation between sICAM-1 levels and the capillaroscopy findings were found, 75% of the patients with severe vascular changes in capillaroscopy exceeded normal sICAM-1 cut off value. Serum sICAM-1 concentrations correlated significantly with the erythrocyte sedimentation rate and serum sIL-2R, but not with the duration of RA, radiological stages, Ritchie index, age or type of treatment. These findings suggest that increased levels of sICAM-1 in serum of RA patients reflect systemic vascular involvement rather than a local vascular injury.

Soluble intercellular adhesion molecule 1 in spondylarthropathies

“…This is in agreement with previous papers [5,6] whereas other studies have reported elevated levels in this condition [7,8]. Our RA patients were older than the SpA patients and controls, but Cush et al [4] and Kuryliszyn-Moskal et al [8] did not find a correlation between slCAM-1 and age in RA.…”

“…In rheumatoid arthritis (RA), several studies have reported normal [5,6] or elevated levels of sICAM-1 [4,7] with sometimes a weak correlation with disease activity [4] or extra-articular features such as vasculitis [5,8]. In a previous study [9] we found an increased expression of LFA-1 on the surface of granulocytes in spondylarthropathies and LFA-1 expression correlated with total IgA levels in the serum of these patients.…”

Impairment of microcirculation in juvenile idiopathic arthritis - studies by nailfold videocapillaroscopy and correlation with serum levels of sICAM and VEGF.

“…Our observations are in agreement with the studies performed in adult RA patients in whom significantly higher levels of sICAM-1 were found in RA patients with clinical signs of systemic vasculitis as compared with those RA patients without clinically apparent vascular involvement. Although no significant correlation between sICAM-1 levels and the capillaroscopy findings were found, in the majority (75%) of the RA patients with severe vascular changes in capillaroscopy, sICAM-1 levels exceeded normal cut off value [23].…”

Clinical Relevance of Cytokines, Chemokines and Adhesion Molecules in Systemic Vasculitis

“…CX3CL1 levels are diminished in RV patients successfully treated with glucocorticoids and other immunosuppressive drugs. The c o r r e l a t i o n b e t w e e n C X 3 C L 1 l e v e l s a n d I C A M -1 e x p r e s s i o n i n R V p a t i e n t s s u g g e s t s endothelial damage and/or vascular inflammation (Blann et al 1995;Boehme et al 1996;Kuryliszyn-Moskal et al 1996). The higher CX3CL1 levels observed in RV patients compared with RA or extraarticular manifestation (EAM)-RA patients may be an indicator of undiagnosed vasculitis in RA patients.…”

“…The ICAM-1 protein, TNF-, and E-selectin are expressed in ECs and perivascular mononuclear cells in areas of microvascular damage in the salivary glands of RV patients (Flipo et al 1997). Furthermore, RV patients have elevated levels of sICAM-1 (Voskuyl et al 1995;Kuryliszyn-Moskal, Bernacka et al 1996;Witkowska et al 2003). In addition, Voskuyl et al (Voskuyl, Martin et al 1995) demonstrated the involvement of ICAM-3 and ICAM-1 in patients with RV.…”