LEVELS OF THE CIRCULATING CELL-ADHESION MOLECULE E-SELECTIN AND DISEASE PROGRESSION IN HIV-INFECTION

The levels of soluble form of E-Selectin (sEs), or endothelial-leukocyte adhesion molecule-1, were measured in 96 sera derived from 72 HIV-infected patients at different stages of the disease, 60 healthy blood donors, and 50 HIV-negative patients with infections, using a quantitative ELISA, Levels of sEs in HIV-infected individuals without AIDS, according to the 1993 classification system of the Centers for Disease Control, were higher than normal- (mean +/- SEM 48 +/- 4 versus 35 +/- 2 ng/ml, p = 0.003). Patients with established AIDS, who were afebrile and had no evidence of acute concurrent infection, had even higher sEs serum levels (70 +/- 9 ng/ml, p = 0.009, compared to those without AIDS), A significant increase in clinical catt:gory disease progression was present. Individual concentrations of sEs correlated directly with levels of soluble intercellular adhesion molecule-1 (p < 0.00001) and IL-2 receptor (p = 0.001), but not with CD4(+) T-cell counts. Zidovudine treatment was not associated with changes in sEs serum levels, Elevated sEs levels were also found in HIV-seronegative patients with other bacterial and protozoal infections, Since sEs is a biologically active molecule, further studies should investigate the pathogenetic significance of circulating sEs in HIV-related disease progression, and assess the prognostic value of sEs determination for these patients.