Levels of VCAM and ICAM In Patients with Allergic Rhino-Conjunctivitis and H1 Antihistamines

Background:  Soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular adhesion molecule-1 (sVCAM-1) play and important role in eosinophilic inflammation in allergic rhino-conjunctivitis (ARC). ICAM-1 and VCAM-1 have been identified as key molecules in allergic inflammatory diseases and in a few studies there was an increased value of those molecules in patients with allergic rhinitis. Treatment with H1 antihistamines is known to improve symptoms in allergic rhinitis and in vitro reduces the levels of adhesion molecules.

The aim of the study was to evaluate serum levels of sICAM-1 and sVCAM-1 in pts with ARC to grass pollen and the response to different antihistamines.

Methods: 50 pts with allergic rhino-conjunctivitis to grass pollen were evaluated regarding levels of sICAM-1 and sVCAM-1. The serum sICAM-1 and sVCAM-1 were evaluated during pollen season before and after antihistaminic terapy. Quantikine® R&D System was used. Normal mean values in healthy volunteers were 208 ng/ml for sICAM and 557 ng/ml for sVCAM-1. 54% of pts were women and 88% from urban area.

Results: Mean levels of sICAM-1 and sVCAM-1 were elevated before therapy of the pts compared with mean values in healthy subjects (235 ng/ml vs. 208 ng/ml for sICAM and 966 ng/ml vs. 557 ng/ml for sVCAM. 42% of pts received desloratadine therapy and 58% of them received levocetirizine. In both treated groups’ levels of sICAM-1 and sVCAM-1 increased after one month of antihistaminic therapy but no statistical significance. Was obtained: in desloratadine group sICAM-1 (p=0.066) and sVCAM-1 (p=0.096); in levocetirizine group sICAM-1 (p=0.681) and sVCAM-1 (p=0.4060.  Patients with high levels of sICAM-1 and sVCAM-1 at the tended to have increased sICAM-1 and sVCAM-1 levels at one month (p=0.000). No statistical difference was obtained between the two treated groups after one month regarding the levels of sICAM-1 and sVCAM-1.

Conclusions: In patients with allergic rhino-conjunctivitis to grass pollen levels of sICAM-1 and sVCAM-1 are higher than in healthy subjects. Levels of sICAM-1 and sVCAM-1 in serum tend to increase during pollen season despite antihistaminic therapy.