Background The soluble forms of adhesion molecules (sAM) may have a regulatory function in inflammatory responses and may serve as useful markers of both leukocyte and endothelial cells activation in different diseases, including several autoimmune disorders. They have been studied in adults with certain rheumatic diseases while studies in paediatric patients are more limited.
Objectives The aim of this study was to compare the levels of sAM in children with juvenile idiopathic arthritis (JIA) and scleroderma and to correlate serum levels of these molecules with conventional inflammatory parameters and to determine differences in these levels among clinical subtypes of JIA.
Methods Soluble forms of AM ICAM-1, VCAM-1, E-selectin and P-selectin were measured by sandwich ELISA in 47 children with JIA, (24 pauciarticular, 7 polyarticular, 16 systemic) and 11 patients with scleroderma. The levels of sAM according to type of disease, JIA type and some inflammatory parameters (ESR, total white blood cell count-WBC, platelet count) were analysed.
Results Differences in serum levels of sAM have been demonstrated among the 3 subtypes of JIA. The highest values were seen in patients with systemic disease, lower values in patients with polyarthritis and pauciarticular form. The statistically significant higher levels of sICAM-1 (p < 0.01) and sE-selectin (p < 0.05) were recorded only in JIA patients with systemic symptoms than in children who were pauciarticular. In systemic JIA, positive correlation was found between sICAM-1 as well as sE-selectin levels and ESR and WBC. Levels of sICAM-1 and sE-selectin were significantly higher in children with abnormal values of ESR versus patients with normal values (p < 0.05 and p < 0.05, respectively). Similarly, significantly higher levels of sICAM-1, sE-selectin and sP-selectin were recorded in cases with higher number of WBC in comparison with others (p < 0.05, p < 0.025, p < 0.02, respectively). In patients with scleroderma sE-selectin level was lower than in polyarticular form (p < 0.05) and the concentration of both sICAM-1 and sE-selectin were significantly lower than in systemic JIA (p < 0.05 and p < 0.05, respectively). In contrast, sVCAM-1 levels were significantly higher only in scleroderma children in comparison with pauciarticular (p < 0.02) and higer than in polyarticular and equal to the systemic group.
Conclusion The preliminary results indicate the role of sVCAM-1 in the pathogenesis of childhood-onset scleroderma and confirm the differences between subtypes of JIA and suggest that sICAM-1 and sE-selectin may be another useful tool of monitoring the activity of systemic JIA.
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