SOLUBLE ENDOTHELIUM-ASSOCIATED ADHESION MOLECULES IN PATIENTS WITH GRAVES-DISEASE

The targeting and recruitment of inflammatory cells to vascular endoth elium in Graves' disease (GD) is mediated by intercellular adhesion mo lecule-1 (ICAM-1), endothelial leucocyte adhesion molecule-1 (ELAM-1), and vascular cell adhesion molecule-1 (VCAM-1). We have studied serum levels of soluble ICAM-1 (sICAM-1), soluble ELAM-1 (sELAM-1), and sol uble VCAM-1 (sVCAM-1) in patients with GD (n = 21) and in patients wit h iodine-deficient goitre (IDG) (n = 23). The serum levels of sICAM-1 were markedly elevated in patients with GD before treatment with thiam azole (median 560 ng/ml versus 185 ng/ml in patients with IDG). In add ition, elevated serum concentrations of sELAM-1 (median 85 ng/ml versu s 33 ng/ml, respectively) and sVCAM-1 (median 42 ng/ml versus 15 ng/ml , respectively) were observed in patients with GD (P < 0.01 for all). The serum levels of sELAM-1 and sVCAM-1 dropped significantly after in itiation of therapy and were within the normal range after 4, and 8 we eks of therapy, respectively. Serum levels of sICAM-1 were elevated ev en after 8 weeks of therapy. Serum levels of sVACM-1 and sICAM-1 corre lated with the serum concentrations of anti-thyroid-stimulating hormon e (TSH)-receptor antibodies (TSHR-R) (n = 21; r = 0.929 and r = 0.810, respectively) and anti-thyroid peroxidase antibodies (TPO-Ab) (n = 21 ; r = 0.673 and r = 0.750, respectively). However, no correlation betw een sELAM-1 and TPO-Ab, TSHR-R, and anti-thyroglobulin antibodies (Tg- Ab), respectively, could be found. In addition to thyroid hormones and autoantibodies, serum concentrations of sELAM-1 and sVCAM-1, but not sICAM-1, could be useful as clinical markers for disease activity.