Circulating levels of soluble E-selectin, ICAM-1 and VCAM-1 in bullous pemphigoid during low-dose methotrexate therapy - A prospective study

Soluble iso-forms of cellular adhesion molecules (sCAMs) have been describe d and reported to be elevated in various inflammatory diseases. Elevated le vels of sE-selectin have recently been detected and found to correlate with the number of blisters in bullous pemghigoid (BP) during oral corticostero id therapy. in this prospective study we analysed levers of sCAMs in 10 eld erly BP patients during low-dose oral pulse methotrexate monotherapy. We us ed standardised ELISA kits for soluble intercellular adhesion molecule-1 (s ICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and sE-selecti n on 65 sera from 10 patients and 19 controls. Results were correlated with clinical parameters. Before therapy, we found significant elevation of sE- selectin (P = 0.004) and sVCAM-1 (P = 0.002) but not of sICAM-1. sE-selecti n levels decreased during the efficient therapy and correlated with the num ber of blisters. Our results further support the proposition that sE-select in might be a future clinical and predictive tool; but whether the elevatio n of sVCAM-1 also might reflect the disease activity in BP needs more inves tigation. The findings also indicate that BP might be more a cellularly med iated disease where interactions of different adhesion molecules play a cru cial role.