SOLUBLE ADHESION MOLECULES IN SERA OF PATIENTS WITH LEPROSY - LEVELS OF SOLUBLE INTERCELLULAR-ADHESION MOLECULE-1 (SICAM-1) RAPIDLY DECREASE DURING MULTIDRUG THERAPY

The clinicopathological spectrum of leprosy is associated with an alte red immunological reaction. The expression of adhesion molecules on en dothelial cells directs the cellular traffic to sites of local skin an d nerve inflammation. Soluble forms of adhesion molecules, which are r eleased upon cytokine activation, can be detected in the circulation a nd may reflect ongoing tissue inflammation. We determined the serum le vels of sICAM-1, sE-selectin and sL-selectin in 74 patients with lepro sy (tuberculoid form, n = 23; lepromatous form, n = 36; acute leprous reaction, n = 16) and 15 healthy age- and sex-matched control donors. Patients with lepromatous leprosy had significantly higher levels of s ICAM-1 (564 +/- 174 versus 450 +/- 92 versus 334 +/- 57 ng/ml) and E-s electin (90 +/- 31 versus 74 +/- 29 versus 50 +/- 10 ng/ml) than patie nts with tuberculoid leprosy and normal donors (P < 0.01). No differen ces between groups were detected for L-selectin. Patients with leprous reactions had similar high levels to lepromatous patients. Twenty lep romatous patients were re-examined after 4 weeks of therapy. A signifi cant decrease in sICAM-1 serum levels was observed after 1 month of an ti-mycobacterial treatment, which was accompanied by a reduction of my cobacteria in skin biopsies (P < 0.01). Patients with leprous reaction s (n = 13) also demonstrated a drop in sICAM-1 after anti-inflammatory therapy. sE-selectin and sl-selectin serum values decreased only in l epromatous patients after therapy. It can be concluded that soluble ad hesion molecules like sICAM-1 and sE-selectin are promising activity m arkers in patients with leprosy, which may be useful for treatment mon itoring.