RESUMO
Pulmonary compromise in systemic sclerosis [SSc] includes pulmonary hypertension [PHT] and interstitial lung disease [ILD] which reflect specific pathological insults, namely, obliterative vasculopathy and fibrosis, respectively. Vascular [endothelial cell] injury and activation are the earliest and possibly primary events in the pathogenesis of SSc. Being one of the endothelium-related indices, serum soluble vascular cell adhesion molecule-1 [sVCAM-1] could be a useful parameter in vascular assessment. The aim of this study was to [1] assess the serum level of sVCAM-1 in SSc patients and [2] investigate any correlation of sVCAM-1 with pulmonary involvement [PHT and ILD] and disease activity. This study was carried out on 15 SSc patients and 10 control subjects of matched age and sex. Each patient was subjected to history taking, full clinical examination, assessment of skin involvement by the modified Rodnan skin score [mRSS], routine laboratory investigations, assay of VCAM-1 by the use of ELISA test and multislice CT for assessment of PHT and ILD. There was a statistically significant increase of serum sVCAM-1 in SSc patients compared to controls [p = 0.0069]. There were no statistically significant differences between sVCAM-1 levels in patients with and without PHT, patients with mild ILD and those with moderate to severe ILD as well as patients with limited and diffuse SSc. No significant correlation could be found in SSc patients between sVCAM-1 levels and mRSS [r = 0.186, p = 0.661], serum creatinine [r = -0.379, p = 0.191] and different grades of ILD [r = -0.154, p = 0.609]. There was a statistically significant correlation between serum sVCAM-1 level and CRP [r = 0.852, p = 0.001]. The increased level of sVCAM-1 among the studied SSc patients could not be strictly attributed to pulmonary endothelial cell activation/damage and its pathologic role could not be verified in this respect by this study. The pattern of its correlation with selected disease activity indices pointed out to its link to the inflammatory stage of SS. Consequently, it could be considered as a non specific marker of inflammation irrespective to the type and extent of systemic organ involvement