BEHAVIOR OF SOLUBLE INTERCELLULAR-ADHESION MOLECULE-1 AND ENDOTHELIAL-LEUKOCYTE ADHESION MOLECULE-1 CONCENTRATIONS IN PATIENTS WITH GRAVES-DISEASE WITH OR WITHOUT OPHTHALMOPATHY AND IN PATIENTS WITH TOXIC ADENOMA

Expression of intercellular adhesion molecule-1 (ICAM-1) and endotheli al-leukocyte adhesion molecule-1 (ELAM-1) on endothelium can be consid ered a critical early step for leukocyte migration from blood to tissu es during inflammatory processes. Increased circulating soluble ICAM-1 (sICAM-1) levels have been found in sera from patients with Graves' d isease IGD, with or without ophthalmopathy. Serum soluble ELAM-1 (sELA M-1) levels have not been measured in these patients. The aim of this study was to clarify the behavior of sICAM-1 and sELAM-1 levels in pat ients with hyperthyroidism due to GD with or without ophthalmopathy an d in hyperthyroid patients with toxic thyroid adenoma. We studied sICA M-1 and sELAM-1 levels in 130 subjects (age 23-54 yr), grouped as foll ows: group 1, 30 untreated hyperthyroid GD patients 121 females and 9 males) with active ophthalmopathy; group 2, 26 euthyroid GD patients ( 16 females and 10 males) with active ophthalmopathy; group 3, 33 hyper thyroid GD patients (22 females and 11 males) without ophthalmopathy; group 4, 11 untreated hyperthyroid patients (7 females and 4 males) wi th single toxic adenoma; and a control group of 30 healthy subjects 12 1 females and 9 males). sICAM-1 and sELAM-1 concentrations were measur ed by a sandwich enzyme linked immunosorbent assay (ELISA) method. Gro ups 1, 2, and 3 (P < 0.001 for all 3 groups) but not group 4 showed in creased sICAM-1 levels compared with the control group. However, group s 1 and 2 (P < 0.001 for both) showed higher values of sICAM-1 than gr oup 3, and group 1 showed higher sICAM-1 levels than group 2 (P < 0.00 2). Groups 1 and 2 (P < 0.001 for both) but not groups 3 and 4 showed sELAM-1 levels significantly higher than the control group and positiv ely correlated to the severity score of Graves' ophthalmopathy (GO) (P < 0.002 for group 1 and < 0.01 for group 2). Our results confirm that increased sICAM levels in GD patients with or without ophthalmopathy (with higher levels in patients with GO) but not in hyperthyroid nonau toimmune patients may be the consequence of orbital and thyroid inflam mation, and they also suggest that sICAM concentrations could reflect the degree of inflammatory activity. Increased sELAM-1 concentrations only, in patients with ophthalmopathy with or without hyperthyroidism significantly correlated to severity score of GO, suggest the measurem ent of sELAM-1 levels as a specific marker of endothelium activation i n GO.