Journal Article

Circulating soluble adhesion molecules in ANCA‐associated vasculitis

Jordi Ara, Eduard Mirapeix, Pilar Arrizabalaga, Rosa Rodriguez, Carlos Ascaso, Rosa Abellana, Josep Font and Alexandre Darnell

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 16, issue 2, pages 276-285
Published in print February 2001 | ISSN: 0931-0509
Published online February 2001 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/16.2.276
Circulating soluble adhesion molecules in ANCA‐associated vasculitis

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Background. To evaluate whether changes in concentrations of soluble (s) E‐selectin, sP‐selectin, sL‐selectin, intercellular adhesion molecule 1 (sICAM‐1), and vascular cell adhesion molecule 1 (sVCAM‐1) reflect disease activity in patients with ANCA‐associated vasculitis and whether serum levels of these adhesion molecules are related to the degree of renal failure in patients with chronic renal failure (CRF).

Subjects and methods. A sandwich ELISA was used to measure these soluble adhesion molecules in (i) sera from 20 patients with antineutrophil cytoplasmic antibody (ANCA)‐associated vasculitis (10 patients with Wegener's granulomatosis (WG) and 10 patients with microscopic polyangiitis (MPA)), obtained at the time of diagnosis and during the remission period; (ii) sera from 40 patients with CRF not undergoing haemodialysis.

Results. At the time of diagnosis, serum levels of sE‐selectin, sICAM‐1 and sVCAM‐1 (88±42 ng/ml, 437±184 ng/ml, 1720±1174 ng/ml respectively) were significantly higher in patients with ANCA‐associated vasculitis than in healthy controls (P<0.0001, P=0.002 and P=0.001 respectively). Serum sP‐selectin values did not differ from those obtained in normal donors. In contrast, sL‐selectin levels (940±349 ng/ml) were significantly lower in patients than those recorded in healthy controls (P<0.0001). A significant decrease in concentrations of sE‐selectin, sP‐selectin, sICAM‐1, and sVCAM‐1 was observed between active and remission phases (P<0.0001, P=0.002, P=0.001 and P=0.001 respectively). No significant differences were observed in sL‐selectin levels between active and remission phases. sL‐selectin concentrations (802±306 ng/ml) during the remission phase remained lower than those observed in healthy controls (P<0.0001). No correlation was observed between serum creatinine and sE‐selectin, sP‐selectin, sICAM‐1 and sVCAM‐1 in patients of the CRF group. A slight negative correlation was established between creatinine and sL‐selectin concentration.

Conclusions. Increased serum levels of sE‐selectin, sICAM‐1, and sVCAM‐1 and decreased levels of sL‐selectin in active ANCA‐associated vasculitis, and the normalization of sE‐selectin, sICAM‐1, and sVCAM‐1 during the remission phase suggest that the concentration of soluble levels of these adhesion molecules reflects disease activity. The decrease in sP‐selectin levels between active and inactive phases also suggest that this receptor may reflect clinical activity.

The lack of correlation between serum levels of sE‐selectin, sP‐selectin, sICAM‐1, and sVCAM‐1 and the degree of renal failure in patients with CRF suggests that the mechanism of clearance of these molecules is not renal.

Keywords: ANCA‐associated vasculitis; disease activity; microscopic polyangiitis; soluble adhesion molecules; Wegener's; granulomatosis

Journal Article.  5573 words.  Illustrated.

Subjects: Nephrology

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