| Intercellular adhesion molecule-1 (1CAM-1), a member of immunoglobulin supergene family, is a kind of single-chained transmembrane glycoprotein. It is the natural ligand of two members of integrin P2 subfamily, namely lymphocyte function associated antigen-l(LFA-l) and Mac-1. ICAM-1 has been shown to play a role through binding with LFA-1 or Mac-1, in a variety of inflammatory and immune-mediated mechanisms, including lymphocyte recruitment and targeting, antigen presentation and recognition, and lymphocyte cytotoxicity. And it has been reported that cellular adhesion by ICAM-1/LFA-1 plays a relevant role in the initiation and infiltration of lymphocytes in the thyroid gland of patient with autoimmune thyroid disease(AITD).In 1990s, in addition to the membrane bound ICAM-1, a circulating form of this molecule, that is soluble intercellular adhesion molecule-1 (sICAM-1), has been described. Recently, markedly elevated serum levels of sIC AM-1 has been reported in patients with Graves' disease and Hashimoto's thyroiditis.Objectives: To evaluate sICAM-1 serum levels in patients with untreated Graves' disease(GD), untreated Hashimoto's thyroiditis(HT), simple goitre(SG),and nontoxic nodular goitre(NTNG). Furthermore, to observe its relation with the Graves' ophthalmopathy and the relapse of GD after withdrawal of antithyroid drug(ATD) and its alteration trend during the course of ATD treatment in GD patients and to investigate its clinical significance. Methods: 58 untreated GD patients(14/58 with ophthalmopathy,GO), 33 untreated HT patients, 17 untreated SG patients, 9 untreated NTNG patients, 428 GD patients in different stage of ATD treatement (76 for 1-3 months,74 for 4-6 months,33 for 7-9 months,54 for 10-12 months,60 for 13-18 months,60 for 19-24 months,23 for 25-36 months,34 for more than 36 months, and 14 for ATD halted, respectively), 50 recurrent GD patients, and 273 healthy individuals as a controlgroup were investigated. Their serum sICAM-1 levels were measured with 1I-sICAM-l RIA, which was established by our laboratory. Results: There was no significant difference between SG group(x?) (193. 82 ?2. 38 ng/ml),NTNG group(159. 31 ?8. 73 ng/ml) and control group(149.89 ?9.45 ng/ml), whereas the levels in untreated GD and HT patients(255. 04?82. 40, 227. 22 ?7. 08, P<0.001,respectively) were elevated in comparison with those in control group. The serum sICAM-1 concentrations in untreated GO patients were higher than those in GD patients without ophthalmopathy(287. 36 ?9. 20 VS. 244. 75?1. 58 ng/ml), however, the difference was not significant. The recurrent GD patients with or without ophthalmopathy both had higher sICAM-1 levels (268. 76 ?70. 32, 265. 32 ?100. 61ng/ml,respectively) than control group(P<0.001).In steadily euthyroid patients receiving ATD, a trend was found that sICAM-1 levels declined gradually, but slowly. Especially in GD patients without ophthalmopathy, sICAM-1 levels was significantly decreased compared with the onset group after 19-24 months' ATD treatment(197.15?38.38 VS. 244.75 + 81.58 ng/ml),but it remained higher than control even the period of treatment over 36 months(P<0.05). In untreated GD patients, positive correlations with both FT3 and FT4 for sICAM-1 were found (rs=0.472,0.445, respectively; P0.01). In GD patients receiving ATD, serum sICAM-1 positively correlate with FT and negatively with sTSH(rs=0.108, -0.110, respectively; P.05). And in euthyroid GD patients treated with ATD, sICAM-1 levels correlated significantly with TRAb(rs=0.261,P<0.05),but not with TSI. In HT, SG and NTNG patients, no correlation was found between sICAM-1 and free thyroid function or any of the antithyroid antibodies.Conclusions: The sICAM-1 assay is of great importance in detecting the abnormal immune status in AITDs patients and can help to diagnose them. sICAM-1 may help us to estimate curative effect, form a prognosis of GD,prognosticate GD relapse and onset of ophthalmopathy. We think that Graves' disease may be a disease of a long course, and the routine length of ATD treatm...
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