Vascular cell adhesion molecule - a new approach to detect endothelial cell activation in MS and encephalitis in vivo

INTRODUCTION: Leukocyte migration into inflammatory lesions is controlled by adhesion molecules on activated vascular endothelium. Pivotal among these are E-selectin and the vascular cell adhesion molecule-1 (VCAM-1), which are found on very few cell types other than activated endothelium. METHODS: We determined the presence of the soluble form of these adhesion molecules (sE-selectin and sVCAM-1) in serum and CSF of patients with multiple sclerosis (MS), viral encephalitis, and controls, using enzyme-linked immunosorbent assays. RESULTS: MS patients with active, Gadolinium-DTPA-enhancing lesions on magnetic resonance imaging had significantly higher sVCAM-1 serum levels than normal controls. Patients with viral encephalitis had significantly higher levels of sVCAM-1 in serum and cerebrospinal fluid than controls. sE-selectin levels showed no significant variations. CONCLUSION: Activated vascular endothelium controlling leukocyte migration may be demonstrated in MS patients in vivo by determining sVCAM-1 in serum. Furthermore, sVCAM-1 may be useful for monitoring inflammatory activity in central nervous system inflammatory disease.