Soluble Intracellular Adhesion Molecule 1 (sICAM-1) in post-Streptococcal Acute Glomerulonephritis.

Background: Glomerulonephritis associated with infiltration of inflammatory cells such as poly-morphonuclear leukocytes, macrophages and T or B-lymophcytes. This is closely related to the expression of cellular adhesion molecules, such as intercellular adhesion molecule 1 (ICAM-1). In human diseases in which unchecked inflammation contributes to the pathogenesis of the diseases process, soluble forms of adhesion molecules including ICAM-1 are elevated.
Objectives: To study the changes in sICAM-1 that occur in post-Streptococcal acute glomerulonephritis (PSAGN).
Methods: sICAM-1 levels were measured (by ELISA) in 25 children with PSAGN during their initial presentation. Diagnosis of PSAGN was based on the presence of haematuria, transient hypocomplementaemia and positive laboratory evidences of recent Streptococcal infection. Patients were compared to 15 healthy children of matched age and sex.
Results: Patients in the acute attack had significantly higher levels of sICAM-1 when compared to control [median (IQR) =45.17 (40.5-49.5) vs 32.5 (26.5-33.4), ng/ml, P ˂0.0001]. sICAM-1 levels correlated significantly with serum C3 (r = -0.58, p = 0.002), serum creatinine (r = 0.46, p = 0.02), and the severity of both systolic and diastolic hypertension (r = 0.64, p = 0.001 and r = 0.65, p ˂0.0001, respectively). No significant correlation was detected between sICAM-1 levels and the severity of proteinuria, haematuria, or oedema. Out of the studied 25 cases; 15 cases were reassessed 3 months after normalization of their complement level and a significant drop in sICAM-1 was found (p = 0.001).
Conclusions: These results suggest that ICAM-1 may have a pathophysiologic role in PSAGN and that sICAM-1 may be used as a marker for the severity of the disease.