RELATIONSHIP BETWEEN LUPUS NEPHRITIS ACTIVITY AND THE SERUM LEVEL OF SOLUBLE VCAM-1

We measured the serum levels of soluble vascular cell adhesion molecul e-1 (sVCAM-1), soluble E-selectin (sE-selectin) and soluble intercellu lar adhesion molecule-1 (sICAM-1) in 72 patients with systemic lupus e rythematosus (SLE) (including patients with active nephritis) and 33 n ormal control subjects, to investigate the correlation between levels of adhesion molecules and disease and histological activity. Serum sam ples were obtained at the time of renal biopsy in 27 patients with lup us nephritis. The 27 patients were divided into groups according to th e World Health Organization (WHO) class as follows: class I + II, n = 11; class III + IV, n = 13 and class V, n = 3. We also determined the activity index (AI) in these 27 renal biopsy specimens. We obtained se rial measurements of the serum levels of soluble adhesion molecules in 11 patients to examine the difference between active and remission st ages. The serum level of sVCAM-1, but not sE-selectin or sICAM-1, was correlated with parameters of SLE disease activity, including the SLE disease activity index score, the anti-double stranded DNA antibody ti ter, the C3 level, the C4 level and the CH50 level. The serum levels o f sVCAM-1, sE-selectin and sICAM-1 were significantly higher in patien ts with SLE than in controls (P = 0.006, P = 0.0005 and P = 0.04, resp ectively). The serum level of sVCAM-1 was significantly higher in pati ents with active lupus nephritis (WHO classes III and IV) than in pati ents in inactive lupus nephritis (WHO classes I and II) (P = 0.0016). The sVCAM-1 level was significantly elevated in patients with an AI gr eater than or equal to 4 compared with patients with an AI < 4 (P = 0. 0025). The sVCAM-1 level decreased significantly during remission (P = 0.0033). The serum level of sVCAM-1 was elevated in patients with act ive lu?us nephritis (WHO classes III and IV) and in patients with high AI scores. The serum level of sVCAM-1 was correlated with the SLE dis ease activity and decreased during remission. Ther-fore, the sVCAM-1 l evel may be a useful marker of lupus nephritis activity.