Popiolek I, Stygar D, Wizner B, Sanak M, Sydor W, Winiarski M, Dembinski M, Hebzda A, Strzalka M, Hydzik P, Rembiasz K, Kukla M
Department of Toxicology and Environmental Diseases, Jagiellonian University Medical College, Cracow, Poland.
Department of Physiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland.
J Physiol Pharmacol. 2025 Jun;76(3). doi: 10.26402/jpp.2025.3.06. Epub 2025 Jul 16.
Acute-phase viral infections, such as COVID-19, trigger a complex interplay of proinflammatory and regulatory responses, influencing both tissue repair and damage. Intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and platelet endothelial cell adhesion molecule-1 (PECAM-1) play crucial roles in immune activation, regulation, and homeostasis during infection. This study included adult patients hospitalized at the University Hospital in Cracow, Poland, with confirmed SARS-CoV-2 infection between January and June 2021. Blood samples were collected at three time points and categorized based on the time since symptom onset: first, second, or third week of infection. The objective was to assess serum levels of sICAM-1, sVCAM-1, and sPECAM-1 in relation to in-hospital mortality and key biochemical and clinical parameters. Among 276 patients (63% males) with a median age of 62 years, pneumonia was confirmed in 89% of cases, with an in-hospital mortality rate of 12.7%. Mortality was associated with advanced age (71(9) vs. 61(18) years p<0.001) and comorbidities such as hypertension, diabetes, chronic kidney disease, heart failure, and atrial fibrillation. Non-survivors exhibited significantly lower adhesion molecule levels. Median (IQR) concentrations in non-survivors vs. survivors, respectively, were at first week: sICAM-1: 279(114) vs. 399(328) ng/mL (p<0.001); sVCAM-1: 2944(2760) vs. 4670(3331) ng/mL (p<0.001); sPECAM-1: 15(6) vs. 17(7) ng/mL (p<0.05). Results for third week were: sICAM-1: 271(109) vs. 461(296) ng/mL (p<0.01); sVCAM-1: 1875(2034) vs. 1426(1194) ng/mL (p=0.054); sPECAM-1: 18(7) vs. 25(13) ng/mL (p<0.01). Proportionally, sVCAM-1 was highest at symptoms onset, while sICAM-1 and sPECAM-1 rose later. sICAM-1 positively correlated with interleukin-1α, sVCAM-1 was linked to pneumonia and inflammation, and sPECAM-1 negatively correlated with inflammatory markers and D-dimers. These findings highlight the dynamic role of adhesion molecules in COVID-19 and suggest their potential as biomarkers and therapeutic targets for optimizing treatment strategies.
急性病毒性感染，如新冠病毒病（COVID-19），会引发促炎反应和调节反应的复杂相互作用，影响组织修复和损伤。细胞间黏附分子-1（ICAM-1）、血管细胞黏附分子-1（VCAM-1）和血小板内皮细胞黏附分子-1（PECAM-1）在感染期间的免疫激活、调节和稳态中发挥关键作用。本研究纳入了2021年1月至6月期间在波兰克拉科夫大学医院住院的确诊感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的成年患者。在三个时间点采集血样，并根据症状出现后的时间进行分类：感染的第一周、第二周或第三周。目的是评估可溶性细胞间黏附分子-1（sICAM-1）、可溶性血管细胞黏附分子-1（sVCAM-1）和可溶性血小板内皮细胞黏附分子-1（sPECAM-1）的血清水平与住院死亡率以及关键生化和临床参数的关系。在276例患者（63%为男性）中，中位年龄为62岁，89%的病例确诊为肺炎，住院死亡率为12.7%。死亡率与高龄（71（9）岁对61（18）岁，p<0.001）以及高血压、糖尿病、慢性肾病、心力衰竭和心房颤动等合并症相关。非幸存者的黏附分子水平显著较低。非幸存者与幸存者的中位（四分位间距）浓度，在第一周分别为：sICAM-1：279（114）对399（328）ng/mL（p<0.001）；sVCAM-1：2944（2760）对4670（3331）ng/mL（p<0.001）；sPECAM-1：15（6）对17（7）ng/mL（p<0.05）。第三周的结果为：sICAM-1：271（109）对461（296）ng/mL（p<0.01）；sVCAM-1：1875（2034）对1426（1194）ng/mL（p=0.054）；sPECAM-1：18（7）对25（13）ng/mL（p<0.01）。按比例而言，sVCAM-1在症状出现时最高，而sICAM-1和sPECAM-1随后升高。sICAM-1与白细胞介素-1α呈正相关，sVCAM-1与肺炎和炎症相关，sPECAM-1与炎症标志物和D-二聚体呈负相关。这些发现突出了黏附分子在COVID-19中的动态作用，并表明它们作为生物标志物和治疗靶点以优化治疗策略的潜力。
