Soluble adhesion molecules in sera of patients with leprosy: levels of soluble intercellular adhesion molecule-1 (sICAM-1) rapidly decrease during multi-drug therapy

Abstract

SUMMARYThe clinicopathological spectrum of leprosy is associated with an altered immunological reaction. The expression of adhesion molecules on endothelial cells directs the cellular traffic to sites of local skin and nerve inflammation. Soluble forms of adhesion molecules, which are released upon cytokine activation, can be detected in the circulation and may reflect ongoing tissue inflammation. We determined the serum levels of sICAM-1, sE-selectin and sL-selectin in 74 patients with leprosy (tuberculoid form, n 23; lepromatous form, n 36; acute leprous reaction, n 16) and 15 healthy age-and sex-matched control donors. Patients with lepromatous leprosy had significantly higher levels of sICAM-1 6 10 ng/ml) than patients with tuberculoid leprosy and normal donors (P<0 . 01). No differences between groups were detected for L-selectin. Patients with leprous reactions had similar high levels to lepromatous patients. Twenty lepromatous patients were re-examined after 4 weeks of therapy. A significant decrease in sICAM-1 serum levels was observed after 1 month of anti-mycobacterial treatment, which was accompanied by a reduction of mycobacteria in skin biopsies (P<0 . 01). Patients with leprous reactions (n 13) also demonstrated a drop in sICAM-1 after anti-inflammatory therapy. sE-selectin and sL-selectin serum values decreased only in lepromatous patients after therapy. It can be concluded that soluble adhesion molecules like sICAM-1 and sE-selectin are promising activity markers in patients with leprosy, which may be useful for treatment monitoring.

The management of leprosy reversal reactions

“…The intensity of the localized inflammation is reflected by raised serum levels for TNF, 25 soluble IL-2 receptors 26 and adhesion molecules. 27 The institution of effective anti-inflammatory therapy rapidly reverses these abnormalities.…”

The involvement of endothelial mediators in leprosy

“…In leprosy, the elevation of adhesion molecules was demonstrated in different cell types along the spectrum of the disease. Among adhesion molecules evidenced in leprosy, it is possible to highlight the intercellular adhesion molecule-1 (ICAM-1) and its ligand, lymphocyte function-associated antigen-1 (LFA-1) ( Sullivan et al 1991 , Rieckmann et al 1996 ), E-selectin ( Rieckmann et al 1996 ), as well as vascular cell adhesion molecule 1 (VCAM-1) ( Martinuzzo et al 2002 ).…”

T Cell–Monocyte Contact Enhances Tumor Necrosis Factor–α Production in Response toMycobacterium leprae

“…Direct contact with activated peripheral blood T cells, human T cell lines, or membrane preparations of activated T lymphocytes has been demonstrated to stimulate monocytes and monocytic cell lines, in vitro, to produce proinflammatory cytokines, including TNF-a, IL-6, and IL-1b [16][17][18]. Although previous studies have identified significant modulation in integrin expression during ENL reactions [19,20], the synergistic or independent role of cell-cell contact in the generation of TNF-a in leprosy has not been characterized.…”