EVALUATION OF A SOLUBLE E-SELECTIN ENZYME-LINKED-IMMUNOSORBENT-ASSAY UNDER POSTTRAUMATIC CONDITIONS

The up-regulation of E-selectin, one of the adhesion molecules on the endothelium, is an important event in the mediation of the inflammator y response. Because the presence of E-selectin cannot be determined di rectly in vivo except by invasive biopsy techniques, the only availabl e information concerning its activity is the serum level of the solubl e form. Therefore we fried to measure soluble E-selectin levels in tra uma and sepsis situations, where endothelial activation is supposed to occur, We have investigated the soluble E-selectin levels in a group of patients undergoing the trauma associated with cardiac surgery and the use of extracorporeal circulation, some of whom developed a system ic inflammatory response syndrome (SIRS). We have also confirmed that our enzyme-linked immunosorbent assay (ELISA) will detect the revels o f soluble E-selectin that are produced as a result of the exposure of cultured human umbilical endothelial cells to even row revels of endot oxin. The data presented in this paper indicate that in patients with SIRS after extracorporeal circulation, the levels of circulating solub le E-selectin are numerically higher but-at least in this group of pat ients-not statistically significantly different from the levels in pat ients who have undergone the surgery. These results suggest that the m easurement of serum levels of soluble E-selectin is not a reliable met hod for monitoring the onset of SIRS in patients having undergone surg ical trauma, although we have confirmed that our ELISA will detect the levels of soluble E-selectin that ate produced as a result of the exp osure of cultured human endothelial cells to even low levels of endoto xin.