Vascular Cell Adhesion Molecule-l (VCAM-l) in Graves' Disease: Its Association to Thyroid Status and Thyroid Receptor Stimulating Antibodies

Soluble vascular cell adhesion molecule-1 (sVCAM-1) and intercellular adhesion molecule-1 (sICAM-1) have been shown to be elevated in patients with Graves� disease and may play significant roles in the pathogenesis of the disease. The objective of this study was to measure the levels of sVCAM-1, sICAM-1, IL-6 and thyroid receptor stimulating antibodies (TRAb) in a cohort of hyperthyroid patients and determine their associations to thyroid hormones status, before and after 3 months therapy with carbimazole. Materials and Methods: Patients were given fixed daily dose of 20 mg carbimazole for 3 months and blood samples were collected at baseline and end of the study. Thirty eight patients were recruited from the Endocrine Clinic, Hospital University Kebangsaan Malaysia, con-sisting of 26 females and 12 males, age ranging from 16 to 65 years. Blood samples collected be-fore and at end of study were analyzed for TSH, Free T3, Free T4, thyroid receptor stimulating anti-bodies (TRAb), sVCAM-1, sICAM-1 and IL-6. Results: TRAb level of ?10 U/L was taken to be negative, while TRAb level of >10 U/L was considered as positive. Twenty-six patients (68) were TRAb positive (TRAb+) and 12 patients (30) were TRAb negative (TRAb-). Median TRAb in TRAb+ patients was 23 U/L at baseline, declining to 16.7 U/L (p<0.001) in the third 3 month. Serum sVCAM-1 levels were signifi-cantly elevated in TRAb+ patients compared to TRAb- (860 versus 499 ng/mL, p