Abstract
To determine the role of soluble cellular adhesion molecules in the development of multiple organ failure (MOF), serum levels of the soluble type intercellular adhesion molecule-1 (sICAM-1) and the endothelial-leukocyte adhesion molecule-1 (sELAM-1) were measured in 25 patients in the Intensive Care Unit in the Gunma University Hospital. MOF was defined as the failure of two or more organs. The patients were divided into four groups according to the presence or absence of MOF and the systemic inflammatory response syndrome (SIRS): group 1, SIRS (-)/MOF (-); group 2, SIRS (-)/MOF (+); group 3, SIRS (+)/MOF (-) and group 4, SIRS (+)/MOF (+). There were no differences in the serum levels of sICAM-1 and sELAM-1 in group 1, group 2 and group 3. However, the serum levels of both sICAM-1 and sELAM-1 were significantly elevated in group 4. The serum levels of the two molecules tended to increase with the number of dysfunctioning organs. These data suggest that the development of organ dysfunction in a patient with SIRS and MOF (group 4) is associated with the interaction between circulating leukocytes and vascular endothelial cells. The serum levels of sICAM-1 were significantly higher in patients with hyperbilirubinemia, ARDS, CNS disorder and DIC. The serum levels of sELAM-1 were significantly higher in patients with renal failure and DIC. The precise mechanism that caused these difference is not clear. Further investigations are required to clarify the role of sICAM-1 and sELAM-1.
