The present study demonstrated the presence of elevated serum levels of soluble adhesion molecules in patients with chronic neutrophil-mediated airway inflammation, particularly DPB. These results, together with those from other studies, suggest that accumulation of neutrophils in the airway of DPB patients results from infiltration of these cells from the circulation following a series of processes involving several adhesion molecules present on the surface of these cells and cytokine-induced ligands on endothelial cells. This conclusion is supported by recent studies demonstrating a sustained increase of neutrophils as well as their elastase in the lungs of patients with DPB and the presence of enhanced neutrophil related-cytokines in BALF. canadian-familypharmacy.com
Selectins mediate the initial phase of the adhesion cascade, involving neutrophil rolling. These molecules also participate in the inflammatory response associated with neutrophil-dependent acute lung injury. Recent reports have suggested that soluble forms of these selectins in the circulation serve as useful indicators of the severity of acute lung injury it, is t}16 present study demonstrated that the serum levels of sE-selectin and sP-selectin in DPB patients were significantly higher than those in patients with bronchiectasis. Our results also showed a significant correlation between serum levels of sE-selectin and parameters of lung function in DPB patients and between serum levels of sE-selectin and the percentage of neutrophils in BALF in all patients. These findings suggest that soluble adhesion molecules in DPB patients, particularly selectins, may reflect the severity of the disease. The level of sL-selectin in DPB patients, however, was similar to that in bronchiectasis patients despite the significant difference in BALF neutrophils. We could not explain this disrepancy in the present study, but the findings suggest that serum levels of endothelium-derived soluble adhesion molecules may be more reflective on neutrophil infiltration into the lung than those of neutrophil-derived molecules.