CIRCULATING ADHESION MOLECULES IN CYSTIC-FIBROSIS

A marked influx of inflammatory cells occurs into the airways of patie nts with cystic fibrosis (CF), which may contribute to the development of lung injury. Leukocyte-endothelial adhesion molecules play a cruci al role in the recruitment of inflammatory cells, and soluble forms of these molecules have been shown to increase in several inflammatory d iseases. By using a capture ELISA, we determined serum levels of solub le ICAM-1 (sICAM-1), E-selectin (sE-selectin), and VCAM-1 (sVCAM-1) in patients with CF, in stable clinical conditions (n = 29, mean age: 25 .8 +/- 1.5 yr), and healthy control subjects (n = 12, mean age: 27.6 /- 1.5 yr). Clinical, spirometric, microbiological, and hematological assessments were made in all subjects, sICAM-1 and sE-selectin concent rations, but not sVCAM-1 levels were significantly increased in CF pat ients as compared with normal subjects (both p < 0.001). sICAM-1 level s were inversely related to FEV1 values (r = -0.519, p = 0.004) and Sc hwachman score (r = -0.405, p = 0.03) in CF patients. In 7 of 29 CF pa tients, soluble adhesion molecule levels were determined not only at t he time of stable clinical conditions, but also before and after antib iotic treatment for a pulmonary exacerbation. sICAM-1 and sE-selectin levels increased in all patients at the time of the exacerbation, comp ared with levels at the time of stable conditions (p < 0.02 for both c omparisons); antibiotic treatment induced a significant decrease of bo th circulating adhesion molecules (p < 0.02). The elevated serum level s of sICAM-1 and sE-selectin in CF patients, even when they are clinic ally stable, may reflect the marked and persistent inflammatory proces s in the disease.