Serum L-selectin and ICAM-1 in patients with Graves' ophthalmopathy duringtreatment with corticosteroids

Circulating forms Of L-selectin were found to be elevated in several autoim mune diseases. ICAM-1 has been suggested a predictor of the onset of GO. Th e aim of the study was an estimation of serum L-selectin and ICAM-1 in pati ents with Graves' disease with ophthalmopathy during treatment with cortico steroids to assess their potential as a guideline of immunosuppressive ther apy. We detected serum L-selectin and ICAM-1 in three groups of subjects: 2 0 patients with Graves' disease without ophtamopathy (Gd), 17 patients with clinical symptoms of ophthalmopathy (CAS greater than or equal to 3, anamn esis of GO greater than or equal to 1 year) and 24 healthy volunteers. Cort icosteroid therapy consisted of intravenous infusions of metyloprednisolone (MP) and subsequent treatment with oral prednisone (P). The serum samples were collected 24 h before MP, 24 h after MP. 12 +/- 2 days of treatment wi th prednisone and after the end of the corticosteroid therapy. The levels O f Soluble L-selectin and ICAM-1 in the serum were determined by the ELISA m ethod. The statistical significance was estimated by the Mann-Whitney U-tes t. Serum L-selectin and ICAM-1 were significantly increased in patients wit h GO (respectively 1182 +/- 222 and 438 +/- 68 ng/ml) and in patients with Graves' disease without ophthalmopathy (respectively: 1168 +/- 130 and 343 +/- 109) in relation to the controls. After M P treatment in corticosteroid -responsive patients (improvement in CAS :E 1) serum concentration of L-sel ectin and ICAM-1 decreased significantly and gradually increased during sub sequent treatment with prednisone. tn corticosteroid-responsive patients se rum L-Selectin was significantly higher before MP administration and after P treatment in relation to corticosteroid-resistant subjects. Conclusions: 1. Serum L-selectin and ICAM-1 were elevated in patients with active GO 2. Metyloprednizolone decreased levels of the studied adhesion molecules in co rticosteroid-responsive patients with GO 3. Lack of clinical results in cor ticosteroid therapy in patients with a low starting L-selectin level would suggest the possibility of serum L-selectin estimation as a prognostic for immunotherapy efficacy. (C) 2001 Elsevier Science BN. All rights reserved.