Impact of cladribine on soluble adhesion molecules in multiple sclerosis

Background - Soluble forms of vascular cell adhesion molecule-1 (VCAM-1), intracellular adhesion molecule-1 (ICAM-1) and E-Selectin play a role in the regulation of blood-brain barrier damage and represent markers of the clinical course of multiple sclerosis (MS) and magnetic resonance imaging activity. We determined sICAM, sVCAM and sE-Selectin concentrations in the cerebrospinal fluid (CSF) and serum of patients with remitting-relapsing multiple sclerosis before and after cladribine treatment as well as in a control group. Methods - We examined 17 patients diagnosed according to McDonald's criteria. Thirteen healthy age-matched subjects served as controls. The ELISA method was used to measure sICAM-1, sVCAM-1 and sE-Selectin. Results - The concentration of sICAM and sE-Selectin decreased in sera (difference between patients and controls was statistically significant, in the former P < 0.04, in the latter P < 0.0003) but not in the CSF of MS patients after cladribine treatment. Conclusions - The reduction in sICAM and sE-Selectin concentrations after cladribine treatment indicates an immuno-suppressive effect of the drug. The changes in levels of sICAM and sE-Selectin after cladribine treatment reflect disease activity and indicate a reduction in the inflammatory reaction.