Markedly Elevated Soluble Intercellular Adhesion Molecule 1, Soluble Vascular Cell Adhesion Molecule 1 Levels, and Blood-Brain Barrier Breakdown in Neuromyelitis Optica
Akiyuki Uzawa, MD; Masahiro Mori, MD, PhD; Saeko Masuda, MD; Satoshi Kuwabara, MD, PhD
Arch Neurol.?2011;68(7):913-917. doi:10.1001/archneurol.2011.148
Objective? To evaluate the degree of blood-brain barrierdisruption in patients with neuromyelitis optica (NMO) and toclarify whether the levels of soluble intercellular adhesionmolecule 1 (sICAM-1) and soluble vascular cell adhesion molecule1 (sVCAM-1) in patients with NMO can be useful biomarkers forblood-brain barrier breakdown.
Design? Descriptive historical cohort.
Setting? Department of Neurology, Graduate School of Medicine,Chiba University.
Patients? The levels of sICAM-1 and sVCAM-1 in 25 patientswith NMO, 21 patients with multiple sclerosis, and 20 patientswith other noninflammatory neurologic disorders in the serumand cerebrospinal fluid (CSF) were measured using a multiplexedfluorescent magnetic bead–based immunoassay.
Main Outcome Measures? Levels of the soluble adhesion moleculesin serum and CSF and their associations with blood-brain barrierdisruption.
Results? The CSF levels of sICAM-1 and sVCAM-1 increasedin patients with NMO compared with patients with multiple sclerosisand other noninflammatory neurologic disorders (P?< ?.001), and serum levels of sICAM-1 increased in patients with NMO comparedwith healthy control individuals (P?=?.003). The CSFsICAM-1 levels from patients with NMO were correlated with thealbumin quotient (P?=?.02) and the presence of lesionsdetected via gadolinium-enhanced magnetic resonance imaging.
Conclusions? Severe blood-brain barrier breakdown occursin patients with NMO. Measuring adhesion molecules is usefulto evaluate this barrier disruption.