ALTERED LEVELS OF SOLUBLE ADHESION MOLECULES IN RHEUMATOID ARTHRITIS, VASCULITIS AND SYSTEMIC SCLEROSIS

We compared the levels of soluble adhesion molecules E-selectin(sE-selectin), intercellular adhesion molecule-1 (sICAM-1) andvascular cell adhesion molecule-1 (sVCAM-1) alongside von Willebrandfactor (vWf), CRP and rheumatoid factor in 40 patients withRA, 38 with systemic sclerosis (SSc), 35 with vasculitis andin 80 asymptomatic controls. Adhesion molecules were measuredin serum by ELISA, rheumatoid factor by sheep red blood cellagglutination and CRP by immunonephelometry. Compared to controls,increased sE-selectin was found in patients with RA (P = 0.0015),vasculitis (P = 0.0003) and SSc (P = 0.0126), whilst raisedsICAM-1 was found in RA (P < 0.0003), vasculitis (P <0.0003) and SSc (P < 0.0378). sVCAM was lower in RA thanin controls (P = 0.0102), but was unchanged in vasculitis orin SSc. vWf was raised in RA (P = 0.0102), vasculitis (P <0.0003) and SSc (P < 0.0003). In a Spearman's rank analysisof all the data, vWf correlated with sVCAM-1 and sICAM-1 (bothP < 0.001), sE-selectin with sICAM-1 (P < 0.001) and sVCAMwith sICAM-1 (P < 0.005). Levels of rheumatoid factor correlatedwith those of sE-selectin (P = 0.003) and sVCAM-1 (P < 0.012),but there were no correlations between any index and CRP. Thestrongest correlations within the RA group were between sICAMand sVCAM (P = 0.001), in vasculitis it was between sE-selectinand sICAM (P < 0.001), and in SSc it was between sE-selectinand sVCAM (P = 0.019). These data suggest that the differinglevels of vWf, sE-selectin and sICAM-1 in the inflammatory vasculitidesmay be useful in establishing a rolefor leucocyte/endothelialadhesion in these diseases. KEY WORDS: Vasculitis, Rheumatoid arthritis, Systemic sclerosis, von Willebrand factor, Soluble E-selectin, Soluble ICAM-1, Soluble VCAM-1