CIRCULATING CELL-ADHESION MOLECULES IN BRONCHIAL LAVAGE AND SERUM IN COPD PATIENTS WITH CHRONIC-BRONCHITIS

The initial phase of inflammation in bronchial asthma appears to be tr iggered by the expression of leucocyte-endothelial adhesion molecules on endothelial cell surfaces. Cell adhesion molecules (CAMs) cause adh esion of leucocytes to the endothelium prior to their subsequent extra vasation into inflamed tissue. We wanted to determine whether circulat ing intercellular adhesion molecule-1 (cICAM-1) and circulating E-sele ctin (cE-selectin) could be detected in bronchial lavage fluid and ser um in patients with stable chronic obstructive pulmonary disease (COPD ) and chronic bronchitis. Bronchoscopy and small volume bronchial lava ge was performed in 19 patients with COPD and chronic bronchitis and i n 13 control subjects. We found increased mean levels of cICAM-1 both in serum (481 mu g.l(-1)) and in bronchial lavage (24 mu g.l(-1)) in t he COPD patients as compared to the controls (321 pg.l(-1) in serum, 1 5 mu g.l(-1) in lavage). We also found higher mean levels of cE-select in in serum from the COPD patients (86 mu g.l(-1)) compared to control s (50 mu g.l(-1)). The serum levels of cE-selectin correlated signific antly with lung function measured as forced expiratory volume in one s econd (FEV(1)) in percentage of predicted. Patients with significant i ntrabronchial bacterial colonization had increased levels of serum cE- selectin. Our results indicate that cCAMs may reflect an upregulation of CAMs on endothelial and epithelial airway cells in COPD.