Heidenreich F, Arendt G, Jander S, Jablonowski H, Stoll G
Department of Neurology, Heinrich-Heine Universität, Düsseldorf, Germany.
J Neuroimmunol. 1994 Jul;52(2):117-26. doi: 10.1016/0165-5728(94)90105-8.
We measured levels of soluble intercellular adhesion molecule 1 (sICAM-1) in paired serum and CSF samples of 110 HIV-1-positive patients with and without neurological symptoms and 40 HIV-negative non-immune neurological controls, and in sera of 26 asymptomatic HIV-1-positive patients. Serum sICAM-1 levels in asymptomatic HIV-1-positive patients were significantly increased in comparison to HIV-negative controls. Moreover, they were significantly higher in HIV-1-positive patients with AIDS-defining diseases than in the asymptomatic HIV-1-positive group. In subgroups of patients with neurological disease, the highest serum values were found in HIV encephalopathy. CSF levels of sICAM-1 were elevated only in HIV-1-positive patients with neurological disease mainly due to passive diffusion through a defective blood-brain barrier. An sICAM-1 index was calculated as a measure for intrathecal production of sICAM-1 but showed no significant differences between patients with and without neurological involvement. However, increased levels of the sICAM-1 index were found in some patients with opportunistic CNS infection of bacterial or fungal origin. Serum and CSF levels of sICAM-1 correlated with neopterin levels, a marker of interferon-gamma-mediated macrophage activation and CSF sICAM-1 levels were inversely correlated to numbers of CD4+ T cells. Elevated serum sICAM-1 levels already in asymptomatic HIV-1-positive individuals add to the evidence for an early immune activation in HIV infection. With the further increase of serum and CSF s-ICAM-1 in patients with AIDS-defining diseases sICAM-1 could serve as a new surrogate marker similar to neopterin.
我们检测了110例有或无神经系统症状的HIV-1阳性患者以及40例HIV阴性非免疫性神经系统对照者的配对血清和脑脊液样本中的可溶性细胞间黏附分子1（sICAM-1）水平，以及26例无症状HIV-1阳性患者的血清sICAM-1水平。与HIV阴性对照相比，无症状HIV-1阳性患者的血清sICAM-1水平显著升高。此外，患有艾滋病定义疾病的HIV-1阳性患者的血清sICAM-1水平显著高于无症状HIV-1阳性组。在患有神经系统疾病的患者亚组中，HIV脑病患者的血清sICAM-1值最高。sICAM-1的脑脊液水平仅在患有神经系统疾病的HIV-1阳性患者中升高，这主要是由于其通过有缺陷的血脑屏障被动扩散所致。计算sICAM-1指数作为鞘内产生sICAM-1的指标，但在有或无神经系统受累的患者之间未显示出显著差异。然而，在一些细菌性或真菌性机会性中枢神经系统感染患者中发现sICAM-1指数水平升高。血清和脑脊液中的sICAM-1水平与新蝶呤水平相关，新蝶呤是干扰素-γ介导的巨噬细胞活化的标志物，脑脊液sICAM-1水平与CD4+T细胞数量呈负相关。无症状HIV-1阳性个体中血清sICAM-1水平升高进一步证明了HIV感染早期的免疫激活。随着患有艾滋病定义疾病患者血清和脑脊液s-ICAM-1水平的进一步升高，sICAM-1可作为类似于新蝶呤的新替代标志物。
