Serum and Ascitic Levels of Soluble Intercellular Adhesion Molecule‐1 in Patients with Alcoholic Liver Cirrhosis: Relation to Biochemical Markers of Disease Activity and Alcohol Intake

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Abstract
The overexpression of intercellular adhesion molecule‐1 (ICAM‐1) has been shown to be involved in the pathogenesis of various necro‐inflammatory diseases, including alcoholic hepatitis. Shedding of this molecule from cell surfaces results in a circulating form, soluble CAM‐1 (SICAM‐1). In this work, the serum and ascitic concentrations of SICAM‐1 were studied in relation to clinical and laboratory data in patients with alcoholic liver cirrhosis of different disease activities. Elevated circulating concentrations of this adhesion molecule were found in all cirrhotic patients, the highest in those with superimposed sewere alcoholic hepatitis, and the levels in regularly drinking cirrhotics without severe alcoholic hepatitis were likewise significantly higher than in those who had stopped drinking. The serum SICAM‐1 concentration was best related to the serum AST activity, and also exhibited significant correlations with the pro‐thrombin activity, serum bilirubin, albumin, peripheral leukocyte count, Maddrey's discriminant function value, Child grading, and antecedent alcohol consumption. Multivariate regression analysis revealed that the serum AST and prothrombin activities were independent predictors of the circulating SICAM‐1 concentration. The concentration of SICAM‐1 in the uninfected ascitic fluid of cirrhotics was about seven times lower than that in the serum; the ratio of its ascitic and serum levels was lower than that of the ascitic and serum total protein concentrations. These data contradict a significant in‐traperitoneal production of the molecule. It is concluded that the serum SICAM‐1 level may be useful as a marker for the current disease activity (the severity of underlying acute necroinflammatory reactions) in alcoholic liver cirrhosis.