Serum levels of soluble adhesion molecules in stem cell transplantation-related complications

To assess the involvement of vascular endothelial cell activation and damag e in stem cell transplantation (SCT)-related complications, such as acute a nd chronic GVHD and thrombotic microangiopathy (TMA), we investigated the c hanges in serum levels of soluble forms of vascular cell adhesion molecule- 1 (sVCAM-1) and E-selectin (sE-selectin) in SCT, The soluble form of interc ellular adhesion molecule-1 (sICAM-1) was also analyzed. In patients with a cute GVHD (grades II-IV), serum levels of sE-selectin and sICAM-1 increased around onset of GVHD (day 30), While the increase of sE-selectin levels wa s transient, sICAM-1 levels remained high until day 60, In patients with ex tensive chronic GVHD, sVCAM-1 as well as sE-selectin levels significantly i ncreased. The appearance of clinical symptoms was preceded by elevations of sVCAM-1 and sE-selectin levels on day 60, and sICAM-1 levels on days 30 an d 60, For the analysis of TMA, to exclude the influence of GVHD, serum leve ls were measured in auto-SCT patients. Around the onset of TMA, sVCAM-1 and sE-selectin levels significantly increased in patients with TMA without an increase of sICAM-1 levels. These findings support the notion that activat ion and injury of endothelium are commonly involved in the pathogenesis of acute and chronic GVHD and TMA.