Cush J J, Rothlein R, Lindsley H B, Mainolfi E A, Lipsky P E
University of Texas Southwestern Medical Center, Dallas 75235.
Arthritis Rheum. 1993 Aug;36(8):1098-102. doi: 10.1002/art.1780360810.
We sought to assess whether circulating levels of intercellular adhesion molecule 1 (ICAM-1) in patients with rheumatoid arthritis (RA) are elevated and correlate with clinical measures of disease activity and whether this ICAM-1 originates from the synovium.
Circulating ICAM-1 (cICAM-1) levels were determined by sandwich enzyme-linked immunosorbent assay of serum from 61 RA, 18 osteoarthritis (OA), and 11 inflammatory arthritis (IA) patients. In addition, paired serum and synovial fluid samples were collected from 17 RA, 9 OA, and 4 IA patients. The stability of cICAM-1 was assessed by overnight incubation at 37 degrees C. Finally, the potential degradative effects of synovial fluid proteases were assessed by incubation of recombinant soluble ICAM-1 with patient synovial fluid.
RA sera contained significantly greater (P < 0.001) levels of cICAM-1 compared with RA synovial fluid and compared with sera or synovial fluid from the OA and IA patients. Circulating ICAM-1 levels were unaffected by overnight incubation at 37 degrees C and were unaffected by exposure to RA, OA, or IA synovial fluid. Serum levels of cICAM-1 demonstrated a weak, but significant (P < 0.05) correlation with the joint score and erythrocyte sedimentation rate in 25 RA patients treated with nonsteroidal antiinflammatory drugs.
The greatest elevations of cICAM-1 were seen in RA patient sera. In both RA and OA, synovial fluid cICAM-1 levels were consistently lower than serum levels, suggesting that cICAM-1 did not originate in the synovium. Because the production of cICAM-1 can be increased by cytokines (e.g., interleukin-1, tumor necrosis factor alpha), elevated levels of circulating ICAM-1 in RA may be reflective of systemic exposure to elevated cytokine levels.
我们试图评估类风湿关节炎（RA）患者循环中的细胞间黏附分子1（ICAM-1）水平是否升高，是否与疾病活动的临床指标相关，以及这种ICAM-1是否源自滑膜。
采用夹心酶联免疫吸附测定法，测定了61例RA患者、18例骨关节炎（OA）患者和11例炎性关节炎（IA）患者血清中的循环ICAM-1（cICAM-1）水平。此外，还收集了17例RA患者、9例OA患者和4例IA患者的配对血清和滑液样本。通过在37℃下过夜孵育来评估cICAM-1的稳定性。最后，通过将重组可溶性ICAM-1与患者滑液孵育，评估滑液蛋白酶的潜在降解作用。
与RA滑液相比，与OA和IA患者的血清或滑液相比，RA血清中cICAM-1水平显著更高（P<0.001）。循环ICAM-1水平不受37℃过夜孵育的影响，也不受暴露于RA、OA或IA滑液的影响。在25例接受非甾体抗炎药治疗的RA患者中，血清cICAM-1水平与关节评分和红细胞沉降率呈弱但显著（P<0.05）的相关性。
RA患者血清中cICAM-1升高最为明显。在RA和OA中，滑液cICAM-1水平始终低于血清水平，提示cICAM-1并非源自滑膜。由于细胞因子（如白细胞介素-1、肿瘤坏死因子α）可增加cICAM-1的产生，RA患者循环中ICAM-1水平升高可能反映全身暴露于升高的细胞因子水平。
