SUMMARY
Intercellular adhesion molecule, a ligand for the leucocyte integrins CDlla/CD18 (LFA‐1) and CD11b/CD18 (Mac‐1), that plays an important role in a variety of inflammatory and immune‐mediated mechanisms, is strongly expressed in rctroocular connective tissue from patients with Graves’ ophthalmopathy (GO) and involved in lymphocyte attachment to cultured retroocular fibroblasts via the ICAM‐1/LFA‐1‐mediated pathway. Here, we report the detection and functional activity of a soluble form of the ICAM‐1 molecule (sICAM‐1) in sera from patients with GO and other thyroid diseases. Serum concentrations for sICAM‐1 were determined using a highly sensitive ELISA. Compared with normal controls, patients with hyperthyroid or euthyroid GO and patients with Riedcl's invasive fibrous thyroiditis revealed markedly elevated sICAM‐1 serum concentrations (all P 0.0001). In patients with Graves’ disease (GD) without clinical GO and in patients with Hashimoto's thyroiditis (HT), sICAM‐1 levels were elevated to a lesser degree (both P < 0.001). sICAVI‐l serum levels in patients with non‐autoimmune hyperthyroidism due to a toxic adenoma were not significantly different from normal controls. In a separate group of 12 patients with severe inflammatory GO, sICAM‐1 serum levels markedly declined (P < 0.0001) within 3 months of glucocorticoid therapy in nine patients who responded to this form of treatment with a decrease in periorbital inflammation. In contrast, sICAM‐1 serum levels remained unchanged in three patients with poor response to steroids and persistent inflammatory periorbital disease. When tested in a cell adhesion assay, GO sera containing elevated concentrations of sICAM‐1 were found to enhance the attachment of peripheral blood mononuclear cells (PBMC) to interferon‐gamma (IFN‐γ)‐treated retroocular fibroblasts in a dose‐dependent manner, up to a maximal stimulation of approximately 5×5‐fold (P 0.001). This effect was abolished by preabsorption of sera with a MoAb against ICAM‐1 and inhibited, in a dose‐dependent manner, by coincubation with increasing concentrations of purified sICAM‐1. In conclusion, sICAM‐1 concentrations are markedly elevated in sera from patients with GO, and changes in sICAM‐1 serum levels during glucocorticoid therapy closely parallel changes in the degree of inflammation. Given the capacity of sICAM‐l to modulate the adhesion of lymphocytes to retroocular fibroblasts in vitro, sICAM‐1 may play a role in the ongoing immune process within the connective tissue in GO.