Mehmet ŞAHİN, Güner TOKGÖZ, Olcay AYDINTUĞ, Hüseyin TUTKAK

Romatoid artrit'li hastalarda serum ve sinoviyal sıvı '' Soluble intercellular adhesion molecule-1 '' düzeylerinin değerlendirilmesi

Serum Soluble Intercellular Adheslon Molecu-le-1 (slCAM-1) düzeyinin çeşitli inflamatuar hasta-lıklarda artabileceği ve bu artışın hastalık aktivitesi ile korelasyon gösterebileceğine dair yayınlar vardır. Bu çalışmada sistemik otoimmün ve inflamatuar bir hastalık olan Romatoid Artritte (RA) serum ve sinovi-yal sıvı "Soluble intercellular adhesion molecule-1" (sICAM-1) düzeylerinin ölçülmesi ve klinik ve labo-ratuvar aktivite kriterleri ile ilişkisinin incelenmesi amaçlanmıştır. Sinoviyal sıvı slCAM-1 değerleri ile Osteoartritli (OA) hastaların sinoviyal sıvı slCAM-1 değerleri karşılaştın/mistir. Serum sICAM-1 düzeyle-ri 23'ü aktif (17 kadın, 6 erkek, yaş ortalaması: 48+13.5, aralık: 28-68), 21'i remisyonda (16 kadın, 5 erkek, yaş ortalaması: 46.3+9.3, aralık: 32-64) olan 44 Romatoid Artritli (RA) hastada ve 18 sağlık-lı bireyde (11 kadın, 7 erkek, yaş ortalaması:42. + 10.5, aralık:25-63) çalışıldı. RA tanısı 1987 ARA sınıflandırma kriterleri göz önüne alınarak yapıldı. Sinoviyal sıvı sICAM-1 düzeyleri 10 aktif RA'li (8 ka-dın, 2 erkek, yaş ortalaması: 48.1 + 12.2, aralık: 28-68) ve 10 Osteoartritli (OA) (8 kadın, 2 erkek, yaşor-talaması:57.5±9,0, aralık43-70)hastada çalışıldı. sl-CAM-1 düzeyleri sandwıch ELISA yöntemi ile belir-lendi (Bender ve Co, Vienna). slCAM-1 düzeyleri hastalığın aktivitesini gösteren klinik ve laboratuar parametreleri (ESR, CRP, RF) ile ilişkiliydi. Serum sICAM-1 düzeyleri RA 'H tüm vakalarda sağlıklı kont-rollere göre anlamlı olarak yüksekti (1053 ng/ml±436.1 ve 329.8 ng/ml±104.3 sırasıyla) (p0. 05). Aktif RA'li vakaların serum slCAM-1 dü-zeyleri de sinoviyal sıvı değerlerine göre anlamlı oranda yüksek idi (1131 ng/ml+ 503 ve 252 ng/ml±143 sırasıyla) (p0. 05). Serum slCAM-1 düzeyleri aktif RA'li hastalarda sa-bah sertliği süresi, CRP ve RF ile anlamlı olarak iliş-kili idi. Remisyondaki hastalarda ise sadece CRP ile sICAM-1 düzeyleri arasında ilişki mevcut idi.

Soluble intercellular adhesion molecule-1 ( sl-CAM-1 ) levels in the serum and synovial fluid of patients with rheumatid arthritis

Circulating sICAM-1 is known to be elevated in various inflammatory disorders. it is further suggested that elevated levels correlate well with disease activity in several autoimmune disorders. Serum sl-CAM-1 was determined in 44 patients with RA of whom 23 had active disease (17 female, 6 male; mean age 48±13.5 range: 28-68), 21 were in remission (16 female, 5 male, mean age 46.3±9.3, range: 32-64) and 18 healthy controls (11 female, 7 male, mean 7 age 42.9±10.5 range: 25-63). The diagnosis of RA was made according to the 1987 ARA dassification criteria. Syhovial fluidslCAM-1 was determined in 10 patients with active RA(8 female, 2 ma/e, me-an age: 48.1+12.2, range: 28-68) and in 10 patients with OA (8 female, 2 ma/e, mean age: 57.5±9.0, range: 43-70). slCAM-1 was determined by a sand-wich ELISA (Bender and Co, Vienna). slCAM-1 le-vels correlated clinical and laboratory parame-ters(ESR, CRP, RF) of disease activity. Serum levels of slCAM-1 in ali ofRA cases were found to be significantly higher than slCAM-1 levels in the healthy control group (1053 ng/ml±436.1 and 329.8 ng/ml±104.3 respectively) (p0.05). Serum levels of slCAM-1 in active RA cases were also found to be significantly higher than slCAM-1 levels in the synovial fluid (1131 ng/ml+503 and 252 ng/ml+143 respectively) (p0.05). Serum slCAM-1 levels correlated well with morning stiffness, CRP an// RF in the patients with active RA. in patients with remission, sICAM-1 levels correlated with CRP. We suggest that slCAM-1 can be ofsome value in inflammatory diseases but it's not superior to the other methods in the evaluation of the disease activity.

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1. Bevilacgua MP. Endotheiial Leukocyte Adhesion Molecules. Annu Rev. Immunol. 1993;11; 767-804.
2. Cronstein BN, Weıssmann C. The adhesion molecules of inflammation. Arthritis Rheum.1993; 36(2):147-57.
3. Cush JJ, Rothleın R, Lindsley HB, Mainolfi EA, Lipsky PE. Increased levels of circulating intercelluler adhesion molecule-1 in the sera of ,patients vvith rheumatoid arthritis. Arthritis Rheum.1993; 36(8):1098-102.
4. Springer TA. Adhesion receptors of the immııne system : Nature; 1990; 346:425-34.
5. Dougherty CJ, Murdoch S, Hogg N. The function of human intercellular adhesion molecule-1 (ICAM-1) in the generation of an immune- response. Eur J Immunol.1988;18:35-9.
6. Smith GW , Marlin SD, Rothleın R, Tornan C, Anderson DC. Cooperative interactions of LFA-1 and Mac-1 with intercellular adhesion molecule-1 in facilitating adherence and transendotheiial migration of human neutrofils.J Clin Invest. 1989; 83:2008-17.
7. Gearing A]H, Newman W . Circulating adhesion molecules in disease. Immunology Today.1993;14:506-12.
8. Rothlein R, Mainolfi EA, Czojkowsi M. and Marlin SDA form of circulating ICAM-1 in human serum. J.İmmunol.1991; 147:3788-93.
9. Seth R, Raymond FD, Makgoba MW . Circulating ICAM-1 isoforms:diagnostic prospects for inflammatory and immune disorders. Lancet 1991; 338:83-4.
10. Adams DH , Mainolfi E, Burra P, Neuberger JM, Ayres R, Elias E, Rothlein R. Detection of circulating intercellular adhesion molecule-1 in chronic liver diseases. Hepatology.1992; 16:810-14.
11. Furukavva S, Imai K, Matsuraba T, Yone K, Yachi A, Okumura K, Yabuta K. Increased levels of circulating intercellular adhesion molecule-1 in Kavvasaki disease. Arthritis Rheum. 1992; 35:672-7.
12. Mason JC, Kapahi P, Haskard DO. Detection of inereased levels of circulating intercellular adhesion molecule-1 in some patients with rheumatoid arthritis but not in patients vvith systemic lupus erythematosus: Arthritis Rheum.1993; 36(4):519-27.
13. Sfikakis PP, Tesar J, Baraf H, Lipnick R, Klipple G, Tsokos GC. Circulating intercellular adhesion molecule-1 in patients vvith systemic sclerosis.Clin Immunol and Immmunopathol.1993; 68:88-92.
14. Machold KP, Kıener HP, Granınger W , Granınger WB . Soluble intercellular adhesion molecule-1 (slCAM-1) in patients with rheumatoid arthritis and systemic lupus erythematosus:Clin Immunol and Immunopathol. 1993; 68(1 ):74-8.
15. Hale LP, Martin ME, M c Colhum DE, Nunley JA, Sprınger TA, Singer KH, Haynes BF. Immunohistologic analysis of tlıe distribution of celi adhesion molecules vvith in the inflammatory synovial microenvironment.Arthritis Rheum.1989; 32:1:22-30.
16. Ishıkavva H, Hirata S, Nishibayashi Y, Imura S, Kubo H, Ohno O. The role of adhesion molecules in synovial pannus formation in rheumatoid arthritis. Clin Ortho Rel Res.1994; 300:297-303.
17. To SS, Nevvman PM, Hyland VJ, Robinson BG, Schrieber L. Regulation of adhesion molecule expression by human synovial rmicrovascular endothelial cells in vitro. Arthritis Rheum.1996; 39(3): 467-77.
18. Panayi GS. The pathogenesis of rheumatoid arthritis and the development of therapeutic strategies for the clinical investigation of biologics. Agents Actions-Supp. 1995; 47:1-21.
19. Aokı S, Imas K, Yachı A. Soluble intercellular adhesion molecule-1 (ICAM-1) antigen in patients vvith rheumatoid arthritis. Scand J Immunol.1993; 38:485-90.
20. Arnett FC, Edvvarthy SM, Bloch DA, M c Shane DC, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liong MH , Luthra HS, Medsger TA Jr, Mitchell DM, Neustadt DH , Pivals RS, Schaller JG, Sharp JT, VVİlder RL, Hunder GG . The American Rheumatism association 1987 revised criteria for the clssification of rheumatoid arthritis. Arthritis Rheum. 1988; 31:315-324.
21. Pinals RS, Masi EF, Larsen LA. Preliminary criteria for clinical remission in rheumatoid arthritis. Arthritis Rheum. 1981; 24:1308-15.
22. Tiilek N, Aydıntuğ O, Tutkak H, Özoran K, Düzgün N, Duman M, Tokgöz G. Sistemik lupus eritematozisli hastalarda soluble intercellular adhesion molecule-1 (sICAM1) düzeyi. 13.Ulusal immünoloji Kongresi. Ankara, 1993; 54.
23. Aydıntuğ O, Tülek N, Tutkak H, Özoran K, Düzgün N, Duman M, Tokgöz G. Sistemik sklerozisli hastalarda soluble intercellular adhesion molecule-1 (slCAM-1) düzeyi. 13.Ulusal immünoloji Kongresi. Ankara,1993; 53.
24. Szekanecz G, Haınes K, Lın TR, Harlovv LA, Goerdt S, Rayan G, Koch AE. Differantial distribution of intercellular adhesion molecules (ICAM-1,ICAM-2 and ICAM-3) and the MS-1 antigen in normal and diseased human synovia. Arthritis Rheum. 1994; 37(2):221-31.
25. Koch AE, Burrovvs JC, Haines GK, Carlos TM, Harlan JM, Lelibovıch JJ. Immunolocalization of endothelial and leukocyte adhesion molecules in human rheumatoid and osteoarthritic synovial tissues. Lab Invest. 1991; 64(3):313-20.
26. Blann AD, Herrick A, Joysan MIV. Altered levels of soluble adhesion molecules in rheumatod arthritis,vasculitis and systemic selerosis. Br J Rheumatol. 1995; 34:814- 19.
27. Aydıntuğ AO, Tokgöz G, Özoran K, Düzgün N, Gürler A, Tutkak H. Elevated levels of soluble intercellular adhesion molecule-1 correlate vvith disease activity in Behçet's disease. Rheumatol Int. 1995; (15):75-8.