Soluble Adhesion Molecules in Children with Glomerulopathy

Background: The adhesion properties of leukocytes are important for the influx and localization of leukocytes in sites of inflammation. Leukocytes adhesion to kidney cells is an early event in renal inflammation as glomerulonephritis.  The adhesion properties are important for the influx and localization of leukocytes in sites of inflammation.
Objectives: To determine whether changes in the levels of soluble adhesion molecules may reflect disease activity in acute post-streptococcal glomerulonephritis (APSGN) or may be related to the degree of renal failure in cases of chronic renal failure (CRF). Also, to find any possible correlation between free radical production in these diseases and the levels of soluble adhesion molecules.
Methods: We measured the levels of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble E-selection (sE-selection) in twenty children with acute post-streptococcal glomerulonephritis (APSGN)  and twenty children suffering from chronic renal failure (CRF) as well as in ten healthy age matched children as a control group. Serum malondialdehyde (MDA: a marker of lipid peroxidation) was also estimated for all subjects to elicit a possible relation between it and the measured adhesion molecules. The antistreptolysin O titer (ASOT) and complement 3 fixation (C3) were performed in the APSGN group. The creatinine clearance was estimated in the CRF group. Serum creatinine was measured in all subjects. The sICAM-1, sE-selection and serum MDA levels were also estimate in eight patients in the CRF group, pre- and post – a 3 hour hemodialysis (HD) session.
Results: The results showed a significant increase in the levels of sICAM-1, sE-selection and MDA in both the APSGN and CRF groups versus the control group, the increase in adhesion molecules being higher in the APSGN group versus the CRF group. This reflects endothelial activation in the groups of patients studied which is more prominent in the APSGN group indicating that the adhesion molecules are probably more involved in the inflammatory stages of renal disease. A significant positive correlation was found between each of sICAM-1, sE-selection and MDA versus ASOT in the APSGN group and the serum creatinine level in the CRF group. A significant negative correlation was found between the creatinine clearance and sE-selection in the CRF group. A non-significant positive correlation was found between each of sICAM-1 and sE-selection versus the MDA levels. Significant decreases in the levels of sICAM-1 and sE-selection were detected in the post-HD versus the pre-HD samples while no change was detected in the MDA levels.
Conclusions: Thus we concluded that the serum levels of sICAM-1 and sE-selection reflect not only inadequate clearance but also enhanced synthesis and/or release of these molecules in both APSGN and CRF. The levels of these molecules as well as MDA reflect disease activity in APSGN and the degree of renal dysfunction in CRF.