VCAM-1, ICAM-1, and E-selectin in IgA nephropathy and Schonlein-Henoch syndrome: Differences between tissue expression and serum concentration

The tissue expressions of vascular cell adhesion molecule 1 (VCAM-1), inter cellular adhesion molecule 1 (ICAM-1) and endothelial leukocyte adhesion mo lecule 1 (E-selectin-l) were investigated in biopsy specimens from 28 patie nts with different stages of IgA nephropathy (IgAN) and 20 patients with ac ute renal failure (ARF) or chronic renal diseases (amyloidosis, Alport's gl omerulopathy) by immunohistochemistry. The results were compared with the s erum levels of the three adhesion molecules. VCAM-1 expression was signific antly increased on parietal/tubular epithelial cells in IgAN and ARF. Signi ficantly elevated circulating VCAM-1 levels were measured in IgAN and amylo idosis, but did not correlate with renal function (creatinine clearance). S ignificantly increased glomerular endothelial/epithelial ICAM-1 expression was found in IgAN and ARF. Intense mesangial ICAM-1 expression was found in mild stages of IgAN and in Schonlein-Henoch syndrome. Circulating ICAM-1 w as not significantly elevated in IgAN and different renal diseases. VCAM-1 and ICAM-1 expressions of interstitial infiltrating cells were significantl y higher in severe than in mild IgAN and associated with an increased infil tration of inflammatory leukocytes. Patients with IgAN and different renal diseases had decreased mesangial and almost absent interstitial E-selectin expression as compared with controls. The circulating E-selectin levels wer e significantly elevated in ARF. In conclusion, the tissue expression of ad hesion molecules in IgAN reflects a continuous inflammatory renal activity. However, only increased circulating VCAM-1 serum levels correlated signifi cantly with the histological state of renal inflammation and could be used as a disease marker.