[The role of adhesion molecules (ICAM-1 and E-selectin) in development of diabetic microangiopathies].

Aim: To examine the expression of the intercellular adhesion molecule-1 (ICAM-1, CD54) on the surface of leukocytes and a soluble E-selectin (CD62) level in patients with diabetes mellitus type 1 (DM1) at various stages of diabetic nephropathy and retinopathy.

Material And Methods: 42 patients with newly diagnosed and long-standing DM1 with presence or absence of microangiopathy (diabetic nephropathy and retinopathy) were examined. Routine laboratory, ophthalmologic tests, a special immunological test with ICAM-1 expression and soluble E-selectin (sES) examination were performed.

Results: The tests show increased ICAM-1 expression and sES level in all the patients vs controls. In newly diagnosed DM1 a high sES level was observed. In long-standing DM1 and absence of microangiopathy a sES level was also high. In patients with neovascularisation and proteinuria the sES level was two times higher than that in other subgroups. We also found an increased percentage of ICAM-1, CD54-positive lymphocytes and granulocytes in patients with microalbuminuria and especially with proteinuria and neovascularization. There were no correlations of ICAM-1 and sES levels with sex, DM duration, cholesterol and triglycerides.

Conclusion: The findings show endothelium and leukocytes activation at early disease stages. Enhanced endothelium and leukocytes activation is associated with late complications.