Differences in levels of soluble E-selectin and VCAM-1 in malignant versusnon malignant mediterranean spotted fever

In the present study, we investigated the plasma levels of soluble adhesion molecules E-selectin, P-selectin, intercellular adhesion molecule-1 (ICAM- 1) and vascular cell adhesion molecule-1 (VCAM-1) in 24 patients with Medit erranean spotted fever (MSF), 6 of whom with a malignant form. Measurements were performed on blood samples collected before treatment (T1), then twic e during treatment (T2 and T3). Before treatment, MSF patients taken as a w hole presented elevated levels of sICAM-1 and sVCAM-1 and normal levels of sE-selectin and sP-selectin compared to healthy controls. We found chat sIC AM-1 was elevated both in mild and malignant MSF. sE-selectin and sVCAM-1 w ere elevated only in patients with the malignant form and allowed to discri minate the two clinical subgroups. Their levels decreased after treatment w ith sE-selectin reaching control values at T2 whereas sVCAM-1 remained high er over the course of the malignant form. In patients with mild MSF, sP-sel ectin steadily increased after treatment, whereas it did not present any mo dification at any of the two sampling times in patients with the malignant form. Raised plasma levels of sE-selectin and sVCAM-1 reflect endothelial a ctivation in malignant rickettsial disease and may be sufficiently early ma rkers to influence the therapeutic decision.