Summary
In the present study, we investigated the plasma levels of soluble adhesion molecules
E-selectin, P-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell
adhesion molecule-1 (VCAM-1) in 24 patients with Mediterranean spotted fever (MSF),
6 of whom with a malignant form. Measurements were performed on blood samples collected
before treatment (T1), then twice during treatment (T2 and T3). Before treatment,
MSF patients taken as a whole presented elevated levels of sICAM-1 and sVCAM-1 and
normal levels of sE-selectin and sP-selectin compared to healthy controls. We found
that sICAM-1 was elevated both in mild and malignant MSF. sE-selectin and sVCAM-1
were elevated only in patients with the malignant form and allowed to discriminate
the two clinical subgroups. Their levels decreased after treatment with sE-selectin
reaching control values at T2 whereas sVCAM-1 remained higher over the course of the
malignant form. In patients with mild MSF, sP-selectin steadily increased after treatment,
whereas it did not present any modification at any of the two sampling times in patients
with the malignant form. Raised plasma levels of sE-selectin and sVCAM-1 reflect endothelial
activation in malignant rickettsial disease and may be sufficiently early markers
to influence the therapeutic decision.
Key Words
Soluble adhesive molecules - endothelial cell - Mediterranean spotted fever