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Elevated Pulmonary Edema Fluid Concentrations of Soluble Intercellular Adhesion Molecule-1 in Patients With Acute Lung Injury*: Biological and Clinical Significance

Edward R. Conner, BS; Lorraine B. Ware, MD; Gunnard Modin, PhD; Michael A. Matthay, MD
Author and Funding Information

*From the University of California, San Francisco, Cardiovascular Research Institute, San Francisco, CA. Supported by grant NIH HL51586.

Correspondence to: Lorraine B. Ware, MD, Cardiovascular Research Institute, Box 0130, 505 Parnassus Ave, San Francisco, CA 94143-0130; e-mail: lware@itsa.ucsf.edu



Chest. 1999;116(suppl_1):83S-85S. doi:10.1378/chest.116.suppl_1.83S
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Extract

Injury to the lung endothelial barrier initiates the accumulation of protein-rich edema fluid in the alveolar space in patients with acute lung injury (ALI). However, recent experimental and clinical data suggest that injury to both the endothelial and epithelial barriers is important to the development and resolution of ALI.12 The recognition of these two potential sites of injury stimulated a study of two biological markers: von Willebrand factor antigen (vWf-Ag) and soluble intercellular adhesion molecule-1 (sICAM-1). vWf-Ag, a high-molecular-weight antigen, is a marker of endothelial activation and injury that we have previously found to be prognostic in patients with sepsis at risk for developing ALI.3 By contrast, sICAM-1, a low-molecular-weight adhesion molecule, is both an epithelial and endothelial marker; in addition to being identified on the alveolar capillary endothelium, it is found in high concentrations on the alveolar epithelium45 and is released in soluble form into the alveolar space in the setting of lung injury.4,6


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