Bonomini M, Reale M, Santarelli P, Stuard S, Settefrati N, Albertazzi A
Institute of Nephrology, Department of Medicine and Aging, University of Chieti, Italy.
Nephron. 1998 Aug;79(4):399-407. doi: 10.1159/000045084.
Besides cell-bound adhesion molecules, which are of fundamental importance to a large number of physiological and pathological processes, soluble forms of adhesion molecules have been detected in the circulating blood in recent years. Circulating soluble adhesion molecules appear to be biologically active, and raised levels have been reported in a variety of disorders. In the present study, we used ELISA to measure the serum levels of four soluble adhesion molecules in 23 undialyzed patients with chronic renal failure (CRF), 13 patients on continuous ambulatory peritoneal dialysis (CAPD), 17 on chronic hemodialysis (HD) and 18 healthy controls having a similar mean and distribution of ages. The investigated soluble (s) molecules included intercellular adhesion molecule 1 (sICAM-1), vascular cell adhesion molecule 1 (sVCAM-1), sE-selectin and sP-selectin. sICAM-1 was found to be elevated in patients with CRF (p < 0.05), on CAPD (p < 0.02) and HD (p < 0.0001) compared with the controls but levels did not differ between the three patient groups. The higher sVCAM-1 values found in CRF (p < 0.02), CAPD (p < 0.05) and HD (p < 0.0001) as compared to controls again failed to differentiate the three groups of patients. Soluble E-selectin was also raised in the three groups (p < 0.0001) with no difference between them. Increased sP-selectin was found in CRF (p < 0.05), CAPD (p < 0.02) and in HD patients (p < 0.0001) compared to controls, and levels in HD were significantly higher (p < 0.02) than in CRF patients. Predialysis serum molecule levels did not differ between HD patients treated with cuprophan or with polyacrylonitrile dialyzers. HD sessions with both dialyzers had no effect on sICAM-1, while a decrease (p < 0.02) in sP-selectin was found after dialysis with cuprophan. In undialyzed patients with CRF, regression analysis showed a strong linear correlation between serum creatinine and serum levels of each soluble molecule. These results demonstrate that serum levels of soluble adhesion molecules ICAM-1, VCAM-1, E-selectin and P-selectin are elevated in both undialyzed patients with CRF and patients on CAPD or HD. The elevated serum levels of these proteins probably reflect inadequate clearance as well as enhanced synthesis/release.
除了对大量生理和病理过程至关重要的细胞结合黏附分子外，近年来在循环血液中也检测到了黏附分子的可溶性形式。循环可溶性黏附分子似乎具有生物活性，并且在多种疾病中都有报道其水平升高。在本研究中，我们使用酶联免疫吸附测定法（ELISA）测量了23例未透析的慢性肾衰竭（CRF）患者、13例持续性非卧床腹膜透析（CAPD）患者、17例慢性血液透析（HD）患者以及18名年龄均值和分布相似的健康对照者血清中四种可溶性黏附分子的水平。所研究的可溶性（s）分子包括细胞间黏附分子1（sICAM - 1）、血管细胞黏附分子1（sVCAM - 1）、sE - 选择素和sP - 选择素。与对照组相比，发现CRF患者（p < 0.05）、CAPD患者（p < 0.02）和HD患者（p < 0.0001）的sICAM - 1水平升高，但这三组患者之间的水平并无差异。与对照组相比，CRF患者（p < 0.02）、CAPD患者（p < 0.05）和HD患者（p < 0.0001）的sVCAM - 1值更高，同样未能区分这三组患者。三组患者的可溶性E - 选择素水平也均升高（p < 0.0001），且组间无差异。与对照组相比，CRF患者（p < 0.05）、CAPD患者（p < 0.02）和HD患者（p < 0.0001）的sP - 选择素水平升高，且HD患者的水平显著高于CRF患者（p < 0.02）。使用铜仿膜或聚丙烯腈透析器治疗的HD患者透析前血清分子水平无差异。两种透析器进行的HD治疗对sICAM - 1均无影响，而使用铜仿膜透析后sP - 选择素水平下降（p < 0.02）。在未透析的CRF患者中，回归分析显示血清肌酐与每种可溶性分子的血清水平之间存在强线性相关性。这些结果表明，未透析的CRF患者以及CAPD或HD患者血清中可溶性黏附分子ICAM - 1、VCAM - 1、E - 选择素和P - 选择素的水平均升高。这些蛋白质血清水平升高可能反映了清除不足以及合成/释放增强。
