CLINICAL VALIDITY OF INTERCELLULAR-ADHESION MOLECULE-1 (ICAM-1) AND TSH RECEPTOR ANTIBODIES IN SERA FROM PATIENTS WITH GRAVES-DISEASE

We compared the concentrations of soluble intercellular adhesion molec ule-1 (sICAM-1) and the activities of thyroid-stimulating antibodies ( TSAb) and thyrotropin-receptor antibodies (TBIAb) as measured with a c ommercial kit (TRAK). Sera were obtained from patients with Graves' di sease (GD) before, during and after therapy with carbimazole (1-methyl -2-thio-3-carbethoxyimidazole). In all the situations, TSAb method was more sensitive than TBIAb. These two parameters dropped during therap y and were not correlated at any stage of measurement. sICAM-1 levels increased in 56.4% of patients before treatment, remained elevated at the beginning of treatment and decreased after twelve months of therap y. TSAb levels were significantly different between patients in relaps e (78%) and those in remission (18%) (Z = -2.250, P = 0.025). with a r elapse rate depending on the TSAb positivity (chi(2) = 7.103, P = 0.00 77). Positive sICAM-1 values were found in 3 of the 9 (33.3%) patients who relapsed after discontinuing the drug but were negative in all th e patients remaining in remission with a significant difference (Z = - 1.982, P = 0.0475). The relapse rate was also dependent on positive sI CAM-1 values (chi(2) = 3.958, P = 0.0466). No correlation was found be tween sICAM-1 levels and anti-TSH receptor antibodies TSAb or TBIAb. W e conclude that the TBIAb technique is too insensitive to explore GD. TSAb and sICAM-1 assays in patients with GD are good markers of immune process after treatment withdrawal. Because of its rapid implementati on, the sICAM-1 assay may advantageously replace TSAb measurement for forming a prognosis of GD. (C) 1997 Elsevier Science B.V.