ELEVATED LEVELS OF SOLUBLE ADHESION MOLECULES IN SERUM OF PATIENTS WITH DIFFUSE PANBRONCHIOLITIS

Study objective: Adhesion molecules have been implicated in the pathog enesis of inflammatory diseases. This study was designed to determine whether soluble adhesion molecules in serum reflect the disease activi ty in diffuse panbronchiolitis (DPB). Patients and methods: Using an e nzyme-linked immunosorbent assay, we measured the serum levels of solu ble L-, E-, and P-selectin (sL-, sE-, and sP-selectin), intercellular adhesion molecule-1, and vascular cell adhesion molecule-1 in 27 patie nts with DPB, 13 with bronchiectasis, and 15 normal adults. BAL was al so performed, and the levels of interleukin (IL)-8 and IL-1 beta in BA L fluid (BALF) were measured. Results: The serum levels of these molec ules were significantly elevated in DPB patients compared with the con trol subjects. DPB patients also had significant high levels of circul ating sE- and sP-selectin compared with patients with bronchiectasis. There was a significant correlation between serum sE-selectin and the percentage of neutrophils in BALF in all patients. There was a signifi cant inverse correlation between serum sE-selectin and percent vital c apacity in DPB patients. In the same patients, the relationships betwe en serum sE-selectin and BALF concentrations of IL-1 beta as well as b etween serum sl-selectin and BALF IL-8 were also significant. Treatmen t of DPB patients with macrolides significantly reduced the serum leve ls of these soluble adhesion molecules and BALF concentrations of IL-1 beta and IL-8. Conclusions: Our results suggest that these soluble ad hesion molecules, particularly selectins, may reflect the disease acti vity of DPB, and that their levels may be regulated by cytokines produ ced in the lungs.