Adhesion Molecules in Collagen V ascular Disorders

Abstract

Collagen vascular disorders are a group of severely distressing and handicapping diseases. Recently, adhesion molecules have come into the picture and are procuring an increased role in the initial diagnosis and follow up of patients with collagen vascular disorders. Soluble forms of adhesion molecules may be found in the circulation and increased levels of other selectins (E-selectin, CD62E and P-selectin, CD62P) have been reported in some connective tissue diseases. This work aims to evaluating the serum level of E-selectin in chi idem with collagen vascular disorders, namely, IRA. Correlation between its level and other laboratory findings in these childern will be sought (e.g. ESR, CRP, WBC count, ANA) to identify the possible use of these adhesion molecules as a parameter for disease activity and response to treatment. Our study included 50 childern: 40 of them were JRA patients and 10 were coming to the hospital due to minor ailments. E-selectin has been found to be significantly elevated in patients with IRA inculded in this study (n=40). E-selectin level was not found to correlate with disease activity whether clinical or laboratory. Corticosteroids have been shown to exert a lowering effect on mean E-selectin level in patients with JRA. However, this decrease can not be used as an indicator of clinical response or improvement and seems to be due to the direct effect of the drug on E-selectin itself and not on the inflammatory process itself since patients on NSAID may show marked clinical improvement inspite of the still high E-selectin levels.