Clinical Significance Of Serum ICAM-1 And VCAM-1 Levels And Neutrophil Receptor Expression In Patients With Primary Sjogren’s Syndrome

Objective: The objective of this study was to detect the levels of intercellular adhesion molecule-1(ICAM-1)and vascular cell adhesion molecule-1(VCAM-1)in serum of patients with primary Sjogren’s syndrome(pSS),and the expression of its receptors,lymphocyte function associated antigen-1(LFA-1)and very late antigen-4(VLA-4)in peripheral blood neutrophils.By analyzing the correlation between the expression levels of the above adhesion molecules and their receptors and clinical indicators,as well as the expressions of ICAM-1,VCAM-1 and neutrophils in labial glands,the clinical significance of these molecules in Sjogren’s syndrome was revealed.Methods: The study included 31 patients diagnosed in the Department of Rheumatology and Immunology of the First Affiliated Hospital of China Medical University with primary Sjogren’s syndrome,20 patients with simple sjogren’s syndrome(non-pSS)with dry mouth or dry eye symptoms but no diagnostic antibodies and characteristic pathological changes of sjogren’s syndrome and no other connective tissue diseases,and 20 healthy controls.Serum ICAM-1 and VCAM-1 levels were examined by enzyme linked immunosorbent assay(ELISA).The expression of LFA-1 and VLA-4 on peripheral neutrophils was examined by flow cytometry(FCM).Immunohistochemical staining(IHC)assessed ICAM-1 and VCAM-1 expression in labial gland biopsy and neutrophil infiltration.Clinical data were collected to analyze the correlation between serum ICAM-1,VCAM-1,neutrophil receptor and clinical indexes.Results: Our results suggested that the serum ICAM-1 levels in pSS patients,non-pSS group and healthy control group were 193.08±41.49ng/ml,158.49±33.65ng/ml and130.97±18.33ng/ml,respectively,with significant differences among the three groups(p<0.01).The serum ICAM-1 level in non-pSS group(p<0.01)and healthy control group(p<0.01)was significantly lower than that in pSS patients,but there was no significant difference between non-pSS group and healthy control group.Serum ICAM-1 level in pSS patients was significantly correlated with white blood cell count,neutrophil count,erythrocyte sedimentation rate,immunoglobulin G,immunoglobulin A and CD4+T cell levels in peripheral blood(all p<0.01).Serum VCAM-1 levels in pSS patients,non-pSS group and healthy control group were 305.59±102.86ng/ml,230.97±103.92ng/ml and200.28±73.47ng/ml,respectively,with significant differences among the three groups(p<0.01).The serum VCAM-1 level in non-pSS group(p<0.01)and healthy control group(p<0.01)was significantly lower than that in pSS patients,but there was no significant difference between non-pSS group and healthy control group.Serum VCAM-1 level in pSS patients was significantly correlated with platelet count,erythrocyte sedimentation rate,and immunoglobulin G and immunoglobulin A expression levels in peripheral blood(all p<0.01).The levels of LFA-1+ neutrophils in peripheral blood of pSS patients,nonpSS group and healthy control group were 7.12%(1.32,13),5.26%(2.42,7.12)and 1.76%(1.16,2.7),respectively,with significant differences among the three groups(p<0.01).Comparison between groups showed that the level of LFA-1+ neutrophil in peripheral blood of non-pSS group(p<0.01)and healthy control group(p<0.01)was significantly lower than that in pSS patients,but there was no significant difference between non-pSS group and healthy control group.The levels of LFA-1+ neutrophils in peripheral blood of pSS patients were significantly correlated with the levels of neutrophil count,white blood cell count,erythrocyte sedimentation rate,CD4+T cells,CD3+T cells,immunoglobulin G and immunoglobulin A in peripheral blood(all p<0.01).The levels of VLA-4+ neutrophils in peripheral blood of pSS patients,non-pSS group and healthy control group were 5%(2.49,9.4),3.85%(2.12,5.71)and 1.43%(0.32,2.6),respectively,with significant differences among the three groups(p<0.01).Comparison between groups showed that the level of VLA-4+ neutrophil in peripheral blood of non-pSS group(p<0.01)and healthy control group(p<0.01)was significantly lower than that in pSS patients,but there was no significant difference between non-pSS group and healthy control group.The levels of VLA-4+ neutrophils in peripheral blood of pSS patients were significantly correlated with immunoglobulin G levels,immunoglobulin A levels and erythrocyte sedimentation rate,in peripheral blood(all p<0.01).The expressions of ICAM-1 and VCAM-1 in labial gland tissue of pSS patients were significantly increased.Neutrophil infiltration was significantly increased.Conclusion: Serum levels of sICAM-1 and sVCAM-1 and their expressions in salivary glands were significantly increased in patients with primary Sjogren’s syndrome.The neutrophil infiltration in salivary glands was also significantly increased.These results suggest that this adhesion molecule may play an important role in the pathological changes of the labial glands in Sjogren’s syndrome by influencing the directed adhesion of neutrophils.