Mrowka C, Sieberth H G
Medizinische Klinik II, Rheinisch-Westfälische Technische Hochschule Aachen, Germany.
Clin Investig. 1994 Oct;72(10):762-8. doi: 10.1007/BF00180543.
Inflammatory systemic disorders with renal tissue damage require the adherence of polymorphonuclear leukocytes to the endothelium, which is mediated by cell surface adhesion molecules. This study measured the serum concentrations of circulating adhesion molecules [intercellular adhesion molecule 1 (cICAM-1), vascular cell adhesion molecule 1 (cVCAM-1), cE-selectin] by sandwich enzyme-linked immunosorbent assay in Wegener's granulomatosis (n = 25) and systemic lupus erythematosus (n = 50). Active Wegener's granulomatosis with cellular crescent formation was associated with significantly raised cICAM-1 levels, an elevated histological activity index, and a high rate of hemodialysis in comparison to Wegener's granulomatosis with fibrocellular crescents or lupus nephritis. The activity index and cICAM-1 levels can be used as parameters to predict renal outcome in Wegener's granulomatosis. cVCAM-1 levels in Wegener's granulomatosis were significantly higher in patients with hemodialysis compared to those without hemodialysis. In lupus nephritis only cVCAM-1, not cICAM-1 or cE-selectin, were significantly higher (P < 0.01) than controls. cVCAM-1 levels in both diseases were significantly higher than in controls. Only in Wegener's granulomatosis did cICAM-1 and cVCAM-1 levels decrease with clinical remission; in systemic lupus erythematosus the levels remained unchanged. cE-selectin levels were not significantly elevated in systemic vasculitis or collagen disease although individual patients revealed high serum concentrations. These data suggest that levels of circulating adhesion molecules reflect different pathophysiological processes in systemic vasculitis and collagen disease and may be used as markers of disease activity and renal outcome.
伴有肾组织损伤的炎症性全身性疾病需要多形核白细胞黏附于内皮细胞，这一过程由细胞表面黏附分子介导。本研究采用夹心酶联免疫吸附测定法，检测了25例韦格纳肉芽肿病患者和50例系统性红斑狼疮患者血清中循环黏附分子[细胞间黏附分子1（cICAM-1）、血管细胞黏附分子1（cVCAM-1）、cE-选择素]的浓度。与纤维细胞性新月体形成的韦格纳肉芽肿病或狼疮性肾炎相比，伴有细胞性新月体形成的活动性韦格纳肉芽肿病患者的cICAM-1水平显著升高，组织学活动指数升高，血液透析率也较高。活动指数和cICAM-1水平可作为预测韦格纳肉芽肿病肾脏预后的参数。与未进行血液透析的韦格纳肉芽肿病患者相比，进行血液透析的患者其cVCAM-1水平显著更高。在狼疮性肾炎中，只有cVCAM-1水平显著高于对照组（P<0.01），而cICAM-1和cE-选择素水平则无显著差异。两种疾病的cVCAM-1水平均显著高于对照组。只有在韦格纳肉芽肿病中，cICAM-1和cVCAM-1水平会随着临床缓解而降低；在系统性红斑狼疮中，这些水平保持不变。尽管个别患者血清浓度较高，但在系统性血管炎或胶原病中，cE-选择素水平并未显著升高。这些数据表明，循环黏附分子水平反映了系统性血管炎和胶原病中不同的病理生理过程，可作为疾病活动度和肾脏预后的标志物。
