DIFFERENTIAL PATTERNS OF CIRCULATING ADHESION MOLECULES IN CHILDREN WITH BRONCHIAL-ASTHMA AND ACUTE BRONCHIOLITIS

The object of the study was to assess the levels of circulating forms of the cellular adhesion molecules ICAM-1, VCAM-1, E-selectin, L-selec tin and P-selectin in young children with asthma and acute bronchiolit is. Thirty-nine children aged 12 to 84 months with mild or moderate as thma were studied at admission for acute asthma (n = 15) or in a stabl e phase (n = 24). Ten of the children with acute asthma were seen agai n after one month. Twenty-two children aged 1 to 17 months with acute bronchiolitis and nine non-atopic controls were also included in the s tudy. In children with acute asthma, the mean concentration of circula ting soluble ICAM-1 (sICAM-1) was increased compared to children with stable asthma (mean 442 mu g/l versus 363 mu g/l; p < 0.001) and to co ntrols (363 mu g/l; p < 0.05). The levels of sICAM-1 remained high at follow up. In children with stable asthma, the mean serum concentratio n of soluble L-selectin (sL-selectin) (2080 mu g/ l) was significantly higher than in the controls (1664 mu g/l; p < 0.05). The levels of ci rculating cellular adhesion molecules were similar in atopic and non-a topic asthmatics. Children with acute bronchiolitis had increased seru m levels of soluble VCAM-1 (sVCAM-1) (1637 mu g/l versus 1019 mu g/l i n the controls; p < 0.01) and sL-selectin (2041 mu g/l versus 1664 mu g/l in the controls; p < 0.05). There was no difference between the le vels of circulating cellular adhesion molecules in children with respi ratory syncytial virus (RSV) positive and RSV negative bronchiolitis. Soluble E-selectin (sE-selectin) and soluble P-selectin (sP-selectin) in serum were not significantly increased in any of the groups studied . In conclusion, our data suggest differential patterns of circulating cellular adhesion molecules in young children with acute asthma, stab le asthma, and acute bronchiolitis, which may reflect differences in t he underlying inflammatory processes in these obstructive pulmonary di seases.