SOLUBLE ADHESION MOLECULES IN BEHCETS-DISEASE

Background: Behcet's disease (BD) may lead to blindness in up to 25% o f eyes. Soluble (s)ICAM-1 but not sVCAM-1 is associated with relapse i n idiopathic uveoretinitis and is reported to be raised in ED patients . We have investigated the levels of sICAM-1 and sVCAM-1 in Palestinia n patients with ED and related them to both ocular and systemic diseas e activity and to immunosuppressive treatment. Methods: A total of 51 patients (43 male, 8 female; mean ages 29.8 & 31.9 yr) were examined a t the St John Ophthalmic Hospital during a one year period (135 consul tations). Disease activity was determined from history and standard oc ular examination. Anterior uveitis, vitritis and retinal vasculitis ac ted as markers of ocular inflammation. Peripheral venous sICAM-1 and s VCAM-1 levels were determined by standard ELISA. A total of 53 healthy age- and sex-matched clinic staff members acted as controls. Results: sICAM-1 and sVCAM-1 were both significantly lower in patients on syst emic immunosuppression than in those off treatment (p<0.001). Among pa tients off systemic treatment, sICAM was higher in the group with acti ve systemic disease but quiet eyes (p=0.003), but not in those with ac tive ocular disease (p=0.09), compared to controls, sVCAM was not rais ed in either group. Conclusion: Systemic immunosuppression was associa ted with reduced sICAM-1 and sVCAM-1, supporting a role for adhesion m olecules in the pathogenesis of ED. sICAM-1 levels were raised in asso ciation with inflammatory features implicating endothelial activation in active ED. The mean sICAM-1 was higher in active ocular patients th an controls, but did not reach statistical significance, emphasising t he need for larger studies which include patients with active features of disease but who are off systemic treatment.