Soluble adhesion molecules in juvenile rheumatoid arthritis

Objective. To determine serum levels of soluble (s) adhesion molecules in p atients with juvenile rheumatoid arthritis (JRA), and to determine whether differences exist in these levels among the 3 subtypes of JRA, and whether levels of these molecules correlate with other measures of disease activity . Methods. Serum levels of soluble forms of intercellular adhesion molecule-1 (ICAM-1), ICAM-3, vascular CV) CAM-1, L-selectin, and E-selectin were dete rmined by sandwich ELISA in 16 patients with JRA (6 systemic, 6 polyarticul ar, 4 pauciarticular). Differences in levels among JRA subtypes were determ ined by ANOVA, and correlations between levels and the following clinical v ariables were assessed by linear regression analysis: erythrocyte sedimenta tion rate (ESR), total white blood cell count (WBC), hematocrit (HCT), plat elet count (PLT), and total swollen joint count (JC). Results. sE-selectin levels were significantly higher in patients with syst emic disease compared to other subtypes (p < 0.04). Furthermore, there was a trend toward higher levels of sICAM-1 in systemic disease, which did not reach statistical significance. Significant correlations were found between sE-selectin and ESR (r = 0.68, p < 0.006), WBC (r = 0.70, p < 0.003), and PLT (r = 0.54, p < 0.05) and between sL-selectin and WBC (r = 0.55, p < 0.0 3). Conclusion. Because of the small number of patients studied, and the lack o f age matched control data, our results must be interpreted with caution. N onetheless, levels of sE-selectin, and possibly ICAM-1 appear to be relativ ely elevated in systemic JRA, and may indicate cytokine induction and endot helial cell activation in that subtype. Several molecules, especially sE-se lectin, correlate with hematologic variables in JRA. These results suggest that serum levels of these molecules may provide a useful additional marker for disease activity in certain patients.