Endothelial cell adhesion molecules in meningococcal disease

Background-Endothelial damage is important in meningococcal disease. Cell a dhesion molecules, including P selectin, E selectin, and intercellular cell adhesion molecule 1 (ICAM-1), are expressed by activated endothelium and t hen subsequently shed. Methods-ICAM-1, P selectin, and E selectin were measured on admission to ho spital in children with meningococcal infections. Results-Concentrations of shed cell adhesion molecules are reported for 78 children. Eleven did not have meningococcal disease. Of the 67 with meningo coccal disease, 40 had mild disease (Glasgow meningococcal septicaemia prog nostic score (GMSPS) < 8) and 27 had severe disease (GMSPS greater than or equal to 8). E selectin and ICAM-1 values were higher in those with meningo coccal disease. The E selectin values in those with severe disease were hig her than in those with mild disease. P selectin concentrations were not alt ered in meningococcal disease, but those who died had lower concentrations. Conclusions-Endothelial activation in meningococcal disease is reflected by shed ICAM-1 and E selectin concentrations.