Increased circulating soluble
ICAM-1 (sICAM-1) levels has been previously reported in
Graves' disease (GD) patients with or without ophthalmopathy (GO) and in patients with toxic
nodular goiter but not in patients with
subacute thyroiditis. Conflicting results have also been reported about the usefulness of sICAM-1 levels as a marker for the activity of
hyperthyroidism. We have therefore determined sICAM-1 levels by a sandwich
enzyme linked
immunosorbent assay (ELISA) method in 10 patients with
subacute thyroiditis (Group 1), who are at the initial or acute phase of
thyroiditis, in 10 hypothyroidic patients with Hashimoto's
thyroiditis (Group 2), in 10 patients with euthyroid
nodular goiter (Group 3), in 10 patients with untreated GD patients with active ophthalmopathy (Group 4), in 10
hyperthyroid GD patients without clinical ophthalmopathy (Group 5), in 10 patients with GO who are euthyroid and treated with
glucocorticoids for 3 months (Group 6) and in 20 normal subjects (Control Group). Groups 1,2,4,5 and 6 (P < 0.00001 for Groups 1,4,5,6 and P < 0.05 for Group 2) but not Group 3 showed increased sICAM-1 levels compared with the control group. However Groups 4 and 6 (patient with GO) showed significantly higher sICAM-1 levels (P = 0.0003 for Group 4 and P = 0.00013 for Group 6) than Group 5. Furthermore Group 4 showed slightly but not significantly higher sICAM-1 levels than Group 6. Mean sICAM levels were significantly decreased 3 months after
glucocorticoid treatment (Group 6), but had not returned to normal levels. Three patients did not respond to
steroid therapy and their sICAM-1 levels were not decreased. We concluded that patients with GO with or without
hyperthyroidism and patients with
subacute thyroiditis have elevated sICAM-1 levels. Moreover, sICAM-1 levels reflect the degree of inflammatory activity in the thyroid gland or orbital tissue independent of the thyroidal status, since we found elevated levels in both
hyperthyroidism and
hypothyroidism.