LEVELS OF SOLUBLE VCAM-1, SOLUBLE ICAM-1, AND SOLUBLE E-SELECTIN IN PATIENTS WITH TUBERCULOUS PLEURITIS

TUBERCULOSIS is characterized by the presence of activated mononuclear cells both in the peripheral circulation and in pleural fluid. Expres sion and up-regulation of adhesion molecules is the basis of cell-cell adhesion in granuloma formation and in leukocyte migration to the inf lammatory site. Soluble isoforms of adhesion molecules have been descr ibed, and their expression at high levels indicated an activated state . The purpose of this study was to evaluate levels of soluble adhesion molecules in serum and pleural fluid from patients with tuberculous p leural effusions, compared with non-tuberculous pleural effusions. We analysed levels of soluble vascular cell adhesion molecule-1 (s.VCAM-1 ), soluble intercellular adhesion molecule-1 (s.ICAM-1), and soluble E -selectin (sE-selectin) in serum and pleural fluid from patients with tuberculous pleuritis, by sandwich ELISA Serum levels of s.ICAM-1 and s.VCAM-1 in patients with tuberculosis were higher than those in healt hy controls (p < 0.001). Levels of sE-selectin levels were in the norm al range compared with control groups. In pleural fluid levels of s.VC AM-1 and s.ICAM-1 were increased in pleural effusions. Patients with t uberculous pleural effusion exhibited high levels of s.ICAM-1 compared with patients with neoplastic pleural involvement. Up-regulation of s .VCAM-1 and s.ICAM-1 in serum, along with increased levels of sE-selec tin in pleural effusions from tuberculous patients, may result in tran smigration of activated inflammatory cells inducing pleural damage, wh ich may contribute to the pathological processes involved.