J Neurol (2005) 252 : 146–150 DOI 10.1007/s00415-005-0618-1 ORIGINAL COMMUNICATION Göksemin Acar Fethi I ˙ diman Güldal Kirkali Serkan Özakbas ¸ Gülgün Oktay Handan Çakmakçi Egemen I ˙ diman Intrathecal sICAM-1 production in multiple sclerosis Correlation with triple dose Gd-DTPA MRI enhancement and IgG index JON 1618 Introduction Multiple sclerosis (MS) is an autoimmune, inflamma- tory demyelinating disease localized the central nervous system (CNS). Although the entire pathogenetic mecha- nisms are still obscure, the main pathological event is the adhesion and transmigration predominantly of lymphocytes and macrophages. The recruitment of these cells across the blood brain barrier depends on complex leukocyte-endothelial cell interactions. Surface proteins expressed on leukocyte membranes interact Received: 11 March 2004 Received in revised form: 8 July 2004 Accepted: 19 July 2004 G. Acar, MD Kars¸ıyaka Neurology Outpatient Clinic Dokuz Eylül University I ˙ zmir,Turkey F. I ˙ diman, MD · S. Özakbas ¸, MD · E. I ˙ diman, MD Department of Neurology Dokuz Eylül University I ˙ zmir,Turkey G. Kirkali, MD · G. Oktay, MD Department of Biochemistry Dokuz Eylül University I ˙ zmir,Turkey H. Çakmakçi, MD Department of Radiodiagnostics Dokuz Eylül University I ˙ zmir,Turkey G. Acar, MD () 1738.Sok. No:140/4 Akdeniz Apt. 35540 Bostanlı-I ˙ zmir,Turkey Tel.: +90-2323817 578 Fax: + 90-2323867071 E-Mail: goksemind@yahoo.com ■ Abstract In this study the aim was to evaluate the intrathecal sICAM-1 production in multiple sclerosis (MS) patients during re- lapse and remission. In addition to this, we assessed whether there is a correlation between intrathecal sICAM-1 production and other disease activity markers such as IgG index and gadolinium en- hancement in magnetic resonance imaging (MRI). Twenty four relaps- ing-remitting MS patients were included in the study. Serum and cerebrospinal fluid (CSF) samples were obtained both during relapse and remission. The soluble form of ICAM (sICAM) was measured by the ELISA method in serum and CSF. Cranial MRI with triple dose gadolinium injection was per- formed for each patient both during relapse and remission. Serum levels of sICAM-1 (245.23 ± 92.88 ng/ml) were higher during relapse than those in remis- sion (219.90 ± 110.94 ng/ml), but the difference was not statistically significant. In relapse periods CSF levels of sICAM-1 (1.304 ± 0.92 ng/ ml) were higher than those in re- mission (1.06 ± 0.86 ng/ml), but this was not significant. However, dur- ing relapse periods patients had significantly higher sICAM-1 index values (1.76 ± 0.60) than those found during remission periods (1.01 ± 0.44) (p < 0.05). The IgG index values were higher in relapse periods than in remission (0.88 ± 0.37 vs. 0.67 ± 0.28) (p < 0.005). On T1 weighted images following triple dose Gd injection, at least two or more enhancing lesions were present in 22/24 of the patients (91 %) in relapse and 4/24 of the patients (19 %) in remission. There was strong correlation both between the sICAM-1 index and Gd enhancement (r = 0.72 p < 0.05) and sICAM-1 index and IgG index in relapse (r = 0.69 p < 0.05). In conclusion, there is association be- tween high sICAM-1 and IgG in- dices, as well as between high sICAM-1 index and Gd enhancing MRI lesions in relapsing MS pa- tients. ■ Key words multiple sclerosis · sICAM · IgG index · triple dose gadolinium · MRI