Am. J. Respir. Crit. Care Med., Volume 157, Number 4, April 1998, 1234-1239

Circulating Adhesion Molecules in Cystic Fibrosis

VIRGINIA DE ROSE, ALESSANDRO OLIVA, BARBARA MESSORE, BIANCA GROSSO, CINZIA MOLLAR, and ERNESTO POZZI

Department of Clinical and Biological Sciences, Respiratory Disease Division, University of Turin, Turin, Italy

A marked influx of inflammatory cells occurs into the airways of patients with cystic fibrosis (CF), which may contribute to the development of lung injury. Leukocyte-endothelial adhesion molecules play a crucial role in the recruitment of inflammatory cells, and soluble forms of these molecules have been shown to increase in several inflammatory diseases. By using a capture ELISA, we determined serum levels of soluble ICAM-1 (sICAM-1), E-selectin (sE-selectin), and VCAM-1 (sVCAM-1) in patients with CF, in stable clinical conditions (n = 29, mean age: 25.8 ± 1.5 yr), and healthy control subjects (n = 12, mean age: 27.6 ± 1.5 yr). Clinical, spirometric, microbiological, and hematological assessments were made in all subjects. sICAM-1 and sE-selectin concentrations, but not sVCAM-1 levels were significantly increased in CF patients as compared with normal subjects (both p < 0.001). sICAM-1 levels were inversely related to FEV₁ values (r = 0.519, p = 0.004) and Schwachman score (r = 0.405, p = 0.03) in CF patients. In 7 of 29 CF patients, soluble adhesion molecule levels were determined not only at the time of stable clinical conditions, but also before and after antibiotic treatment for a pulmonary exacerbation. sICAM-1 and sE-selectin levels increased in all patients at the time of the exacerbation, compared with levels at the time of stable conditions (p < 0.02 for both comparisons); antibiotic treatment induced a significant decrease of both circulating adhesion molecules (p < 0.02). The elevated serum levels of sICAM-1 and sE-selectin in CF patients, even when they are clinically stable, may reflect the marked and persistent inflammatory process in the disease.

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