INCREASED SOLUBLE ICAM-1 CONCENTRATION AND IMPAIRED DELAYED-TYPE HYPERSENSITIVITY SKIN-TESTS IN PATIENTS WITH CHRONIC LIVER-DISEASE

Aims/background-Soluble ICAM-1 may act as an antagonist of the membran e bound form, which is essential for the adhesion of leucocytes to end othelial cells. The aim of this study was to investigate whether the p resence of high concentrations of soluble ICAM-1 are related to the im pairment of delayed-type hypersensitivity reactions. Methods-The study population comprised 73 patients (53 men and 20 women) with chronic l iver disease (19 with chronic hepatitis, 36 with cirrhosis and 18 with hepatocellular carcinoma), and 21 age-matched controls (11 men and 10 women). Serum soluble ICAM-1 was measured using an enzyme immunoassay . Skin tests for seven different antigens (tetanus, diphtheria, strept ococcus group C, tuberculin, Candida, tricophyton, and proteus) were c onsidered positive when diameters greater than or equal to 2 mm were r ecorded; the diameters of positive tests were added to calculate a cum ulative score. Results-Patients with chronic liver disease had fewer p ositive skin tests (median 2) and a lower cumulative score (median 7) than controls (median 3 and 12, respectively). Multivariate analysis s uggested the existence of an independent association between alkaline phosphatase and anergy to skin tests and between soluble ICAM-1 concen trations and the cumulative score. Conclusions-The strong association observed between increased soluble ICAM-1 concentrations and impairmen t of delayed-type hypersensitivity skin tests suggests that soluble IC AM-1 may be implicated in the immune depression seen in patients with chronic liver disease.