Lim A G, Wolfhagen F H, Verma A, van Buuren H R, Jazrawi R P, Levy J H, Northfield T C, Schalm S W
Division of Biochemical Medicine, St George's Hospital Medical School, London, UK.
Eur J Gastroenterol Hepatol. 1997 Feb;9(2):155-61. doi: 10.1097/00042737-199702000-00009.
Soluble intercellular adhesion molecule-1 (sICAM-1) is thought to be released by a variety of cells at sites of inflammation, and their serum levels have been used as markers of inflammatory and immune activity. Our aim was to determine the effect of therapy with ursodeoxycholic acid alone and in combination with azathioprine and prednisone on serum sICAM-1 levels in primary biliary cirrhosis.
DESIGN/METHODS: Twenty-four patients with primary biliary cirrhosis and 17 healthy subjects were studied. Primary biliary cirrhosis patients received ursodeoxycholic acid for 12 months and were then randomized in a double-blind fashion to receive prednisone and azathioprine, or placebo in addition to ursodeoxycholic acid.
sICAM-1 levels were significantly higher in primary biliary cirrhosis patients than healthy subjects and fell by a median of 20% after 12 months' therapy with ursodeoxycholic acid (P<0.0004). Addition of azathioprine and prednisone to ursodeoxycholic acid resulted in a further reduction of sICAM-1 levels by a median of 25% (P< 0.01). Reductions in sICAM-1 were accompanied by improvement in liver function tests but not in the lymphocyte activation marker, soluble interleukin-2 receptor.
sICAM-1 levels in primary biliary cirrhosis are reduced by ursodeoxycholic acid. Further reductions were achieved by adding prednisone and azathioprine. These reductions probably reflect an improvement in hepatobiliary excretion and a reduction in cellular production of sICAM-1.
可溶性细胞间黏附分子-1（sICAM-1）被认为是由炎症部位的多种细胞释放的，其血清水平已被用作炎症和免疫活性的标志物。我们的目的是确定单独使用熊去氧胆酸以及与硫唑嘌呤和泼尼松联合使用对原发性胆汁性肝硬化患者血清sICAM-1水平的影响。
设计/方法：对24例原发性胆汁性肝硬化患者和17名健康受试者进行了研究。原发性胆汁性肝硬化患者接受熊去氧胆酸治疗12个月，然后以双盲方式随机分组，接受泼尼松和硫唑嘌呤，或除熊去氧胆酸外还接受安慰剂。
原发性胆汁性肝硬化患者的sICAM-1水平显著高于健康受试者，在接受熊去氧胆酸治疗12个月后，sICAM-1水平中位数下降了20%（P<0.0004）。在熊去氧胆酸基础上加用硫唑嘌呤和泼尼松，可使sICAM-1水平进一步降低，中位数降低25%（P<0.01）。sICAM-1水平的降低伴随着肝功能检查的改善，但淋巴细胞活化标志物可溶性白细胞介素-2受体水平未改善。
熊去氧胆酸可降低原发性胆汁性肝硬化患者的sICAM-1水平。加用泼尼松和硫唑嘌呤可进一步降低sICAM-1水平。这些降低可能反映了肝胆排泄功能的改善以及sICAM-1细胞产生的减少。
