Adhesion Molecules In Children Research Articles

Elevated levels of tissue plasminogen activator and E-selectin in male children with autism spectrum disorder.

Although the etiopathology of autism spectrum disorder (ASD) is not clear, immune dysfunction has been proposed as a mechanism for the pathophysiology of ASD. The purpose of this study is to examine serum levels of tissue plasminogen activator (t-PA) and some adhesion molecules in children with ASD that have not been investigated previously in detail. The study group included 35 male children aged from 2 to 9 diagnosed with ASD according to DSM-V criteria. Soluble platelet endothelial adhesion molecule-1 (sPECAM-1), P-selectin, E-selectin, and t-PA in the serum were determined with enzyme-linked immunosorbent assay. Autism behavior check list (ABC) is used for the assessment of ASD severity. The levels of t-PA (P = 0.025) and E-selectin (P = 0.007) was detected significantly higher in children with ASD than control group. Serum levels of sPECAM-1 showed statistically significant negative correlation with sensory, body and object-use, language, social, and self-help and total scores in the patient group (r = -0.349, P = 0.04; r = -0.411, P = 0.01; r = -0.412, P = 0.01; r = -0.417, P = 0.01, and r = -0.531, P < 0.01, respectively). Serum levels of P-selectin levels showed statistically significant negative correlation with ABC total score in the patient group (r = -0.378, P = 0.03). It may be suggested that t-PA, E-selectin, P-selectin, and sPECAM-1 a crucial role in inflammatory conditions in children with ASD. Autism Res 2016, 9: 1241-1247. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Assessment of brachial artery reactivity, carotid intima-media thickness, and adhesion molecules in pediatric solid tumor patients treated with anthracyclines

ABSTRACTThe aim of this study was to determine subclinical atherosclerosis and endothelial functional disturbance with measurement of carotid intima-media thickness (IMT), brachial artery reactivity (BAR), and levels of serum adhesion molecules in children with solid tumors who were treated with anthracyclines and are actually in complete remission. Fifty patients who were in remission and 30 healthy children were included in the study. Mean ages of patient and control groups were 13.5 ± 4.7 years (range: 3–23 years) and 12.00 ± 4.3 years (range: 4–21 years), respectively. The patients were divided into 3 groups according to cumulative doxorubicin dose: Group 1, ≤100 mg/m2; Group 2, 101–299 mg/m2; Group 3, ≥300 mg/m2. The BAR and carotid IMT were measured in order to determine the endothelial function. The serum adhesion molecule levels in our patients and controls were also measured. The BAR of the patients with cumulative anthracycline dose ≥300 mg/m2 was significantly lower than the patients with cumulative anthracycline dose ≤100 mg/m2 and healthy controls (P =.005 and P =.003, respectively). Also, there was a negative correlation between brachial artery reactivity and increasing cumulative anthracycline dose (r = −.287, P =.044). We also found significant difference between the mean carotid IMT of the patients and the healthy children (P =.041). No statistically significant difference was detected between the serum levels of sICAM-1 (soluble intercellular adhesion molecule-1), sVCAM-1 (soluble vascular cell adhesion molecule-1), sE-selectin of the patients and controls. The use of anthracyclines in pediatric patients with cancer could result in increase of the carotid IMT and endothelial dysfunction.

Adhesion molecules profile in children with bacterial meningitis and sepsis

Adhesion molecules play a role in leukocyte recruitment during central nervous system (CNS) inflammation. This study was designed to investigate the serum and cerebrospinal fluid (CSF) concentrations of adhesion molecules in children with bacterial meningitis for better understanding of their potential role in the pathophysiology of meningitis. Serum and CSF were collected on admission from 40 children who carried the diagnosis of bacterial meningitis. For comparison, age and sex matched 20 children with sepsis and 20 normal children were included as diseased and healthy control subjects, respectively. Endothelial (E) selectin, leukocyte (L) selectin, platelet (P) selectin, intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecules-1 (VCAM-1) were measured. CSF/serum of measured parameters was calculated to estimate ratio. In meningitis, serum soluble (s) sE-selectin, sL-selectin, sP-selectin, sICAM-1, sVCAM-1 was elevated than controls. Compared to sepsis, serum sE-selectin, sL-selectin, s-ICAM, sVCAM-1, CSF-sL-selectin, CSF-sVCAM-1 and sVCAM-1 ratio were elevated while serum sP-selectin was decreased in meningitis. In meningitis, positive correlation was found between CSF-protein and CSF-leukocytes, CSF-sICAM-1, CSF-sVCAM-1; between CSF-sE-selectin and CSF-sICAM-1. This study supports the role for adhesion molecules especially sL-selectin, sVCAM-1 in the pathophysiology of meningitis and suggests their use as biomarkers for meningitis. Presence of discrepancy of CSF/serum ratios for molecules of same molecular weight suggests intrathecal synthesis in addition to diffusion through the disrupted blood-brain barrier.

Modifications in integrin expression and extracellular matrix composition in children with biliary atresia.

The aetiology of biliary atresia (BA) is still unresolved. The study's aim was to investigate the distribution of extracellular matrix proteins and cellular adhesion molecules in children with BA compared to other cholestatic liver disease (CLD) and normal liver architecture (NLA). Liver biopsies were obtained from children with BA (n=13), CLD (n=6) and NLA (n=8). We systematically analysed ultra thin frozen sections from the liver hilum stained with 25 monoclonal antibodies for cellular characterisation, extracellular matrix proteins and adhesion molecules. 2 changes were specifically found in BA: laminin beta1 was reduced in children with BA vs. NLA and CLD. Conversely, integrin alpha 3 was increased in BA vs. NLA and CLD (p<0.05). Furthermore, we detected changes in a similar pattern for both BA and CLD vs. NLA: in BA and CLD perlecan was increased. On the contrary, integrin beta1 and entactin were decreased vs. NLA (p<0.05). Extracellular matrix proteins and adhesion molecules mediate cellular polarity and integrity, development of tubular structures, and proliferation. Therefore, our findings can be important for the understanding of the genesis of BA. The composition of extracellular matrix proteins and adhesion molecules in children with BA differs from NLA and other CLD in distribution of laminin beta1 and integrin alpha 3, which may have implications for genetic, immunologic and environmental associations in BA.

ADHESION MOLECULES IN INTESTINAL DESTRUCTIVE-INFLAMMATORY PROCESS IN THE CHILDREN WITH ULCERATIVE COLITIS

Aim : to study the content of serum soluble cell adhesion molecules in children with ulcerative colitis that mediate the initial and final stages of the migration of leukocytes to the focus of inflammation: sP-selectin (soluble platelet selectin) and Specam-1 (soluble platelet-endothelial cell adhesion molecule 1) as well some earlier unexplored factors associated with their level. Patients and methods : we examined 107 patients with ulcerative colitis aged from 6 up to 17 years. The diagnosis was set on the base of a comprehensive examination. The content of serum soluble adhesion molecules sP-selectin and sPECAM-1 as well cytokine status and neopterin were evaluated by ELISA. Respiratory metabolism was investigated by using chemiluminescent reactions. Results : it was shown that the content of sP-selectin and sPECAM-1 is significantly higher in patients than in the control group, which may influence on the migration of leukocytes into tissues for realization of their effector potential. It is confirmed by morphological analyses of the intestine biopsies, where it was observed the increasing of the number of leukocytes in vascular endothelium and epithelial layer. At the same time strengthening of the oxygen-dependent metabolism of neutrophils, the increase of the concentration of neopterin and tumor necrosis factor α were noted. Conclusions : the correlation of the studied adhesion molecules with a number of inflammatory markers (TNFα (tumor necrosis factor α), free radicals, neopterin) was revealed, which indicates the diagnostic value of serum levels of the membrane antigens. The increase of the concentration of adhesion molecules sP-selectin and sPECAM-1 may be one of the links of the pathogenesis of ulcerative colitis.

Cytokines, cytokine antagonists, and soluble adhesion molecules in pediatric OMS and other neuroinflammatory disorders

ObjectiveTo test for hypothesized disease- and treatment-induced changes in cytokines and adhesion molecules in children with opsoclonus-myoclonus syndrome (OMS). MethodsMultiplex bead assay technology was used for simultaneous measurement of 34 soluble cytokines in cerebrospinal fluid (CSF) and serum. Soluble intercellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) were measured by ELISA. In total, there were 388 children (239 OMS, 114 controls, and 35 other inflammatory neurological disorders (OIND)). ResultsIn untreated OMS, mean CSF IL-6 was elevated 2.3-fold, but 67-fold in OIND, without significant differences in other CSF cytokines. Mean serum concentrations of sIL-2Ra (+50%) and CXCL1 (+70%) (p<0.0001) were also raised. CSF CCL5 was more often detected in untreated OMS than controls (p=0.005), as was serum CCL11 and IL-13 in treated OMS. Mean CSF CCL4 and IL-1Ra were selectively higher in IVIg-treated OMS (p≤0.0001). CSF sICAM-1 was elevated only in OIND (3.3-fold); serum sICAM-1 was higher in untreated OMS (+21%); and sVCAM-1 was not affected. No correlations with OMS severity or duration were identified. ConclusionsNovel cytokine, cytokine antagonist, and soluble adhesion molecule abnormalities due to OMS or treatment were found. However, the normality of much of the data strengthens previous findings implicating B cell mechanisms.

Importance of adhesion molecules for children with congenital heart disease

The aim of our study was to compare the blood levels of adhesion molecules in children with different heart diseases and pulmonary flow rates. In this study, we evaluated the levels of soluble intercellular adhesion molecule-1 and soluble vascular cellular adhesion molecule-1 in blood samples of 65 children with different congenital heart diseases. The patients were divided into four groups according to their pulmonary blood flow. The first group had increased pulmonary blood flow with pulmonary hypertension and left-to-right shunt. The second group had increased pulmonary blood flow without pulmonary hypertension and left-to-right shunt. The third group had decreased pulmonary blood flow with cyanotic congenital heart disease and the fourth group had normal pulmonary blood flow with left ventricle outflow tract obstruction and aortic stenosis. The highest soluble intercellular and vascular cellular adhesion molecule-1 levels with the mean values of 420.2 nanograms per millilitre and 1382.1 nanograms per millilitre, respectively, were measured in the first group and the lowest levels with the mean values of 104.4 and 358.6 nanograms per millilitre, respectively, were measured in the fourth group. The highest pulmonary blood pressure levels were found in the first group. Endothelial activity is influenced not only by left-to-right shunt with pulmonary hypertension, but also by decreased pulmonary blood flow in cyanotic heart diseases. Adhesion molecules are valuable markers of endothelial activity in congenital heart diseases, and they are influenced by pulmonary blood flow rate.

Cytokines and soluble adhesion molecules in children and adolescents with a tic disorder

Aim Dysregulation of the immune system may play a role in tic disorders. We screened for immune disturbances by investigating serum levels of cytokines and soluble adhesion molecules in patients with a tic disorder. Methods Serum levels of interleukin (IL)-2, IL-4, IL-5, IL-10, IL-12, soluble IL-2 receptor (sIL2R), tumor necrosis factor (TNF)-α, interferon (IFN)-γ, soluble vascular cell adhesion molecule-1 (sVCAM-1), and intercellular adhesion molecule-1 (sICAM-1) of 66 children and adolescents with a tic disorder and 71 healthy volunteers were compared. We also addressed possible relations between concentrations of the immune markers and severity of tics and comorbid obsessive–compulsive symptoms. Results Median serum concentrations did not differ significantly between patients and healthy subjects. Serum IL-2 concentrations were positively associated with tic severity ratings; serum IL-12 concentrations negatively with severity ratings of obsessive–compulsive symptoms. Conclusions These preliminary findings do not reveal major immune activation in children with a tic disorder but may suggest more subtle disturbances related to disease expression.

Adhesion molecule levels in serum and cerebrospinal fluid in children with bacterial meningitis and sepsis.

Background:Adhesion molecules play a role in leukocyte recruitment during central nervous system (CNS) inflammation.Aim:This study was designed to compare serum, cerebrospinal fluid (CSF) concentrations of adhesion molecules in children with meningitis and sepsis, and to evaluate their sources.Setting:This study was carried out at Pediatric Department, King Abdulaziz University Hospital from January 2007 to June 2008.Design:Serum and CSF samples were collected on admission from meningitis (n = 40), sepsis (n = 20) patients, and sera from controls (n = 20).Materials and Methods:Endothelial (E), leukocyte (L), platelet (P) selectins intercellular cell adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecules-1 (VCAM-1) were measured using ELISA.Statistics:ANOVA and Spearman's correlations were used. Adhesion molecules with albumin concentration were estimated in CSF/serum to calculate concentration quotients.Results:In meningitis, serum sE-, sL-, sP-selectins sICAM-1, sVCAM-1 levels were higher than controls. Compared to sepsis, serum sE-selectin, sL-selectin, sVCAM-1, CSF-sL-selectin, CSF-sVCAM-1, VCAM-1 ratio and index were higher, while serum sP-selectin was lower than meningitis. sE-selectin ratio, CSF sICAM-1 were higher in meningitis with positive than negative culture. The sE-selectin index was higher in meningitis with neurological complication than those without it. In meningitis, correlation was found between CSF protein and CSF white blood cell counts (WBCs), CSF sICAM-1, CSF sVCAM-1 and between CSF sE-selectin and CSF sICAM-1.Conclusions:This study supports the role of adhesion molecules especially sL-selectin, sVCAM-1 in meningitis and suggests further research to determine their use as biomarkers for meningitis and use of their antagonists as therapeutic for CNS inflammation. The presence of discrepancy of CSF/serum ratios for molecules of same molecular weight suggest intrathecal shedding in addition to diffusion through the blood-CSF barrier.

Immunologic Changes in TNF‐alpha, sE‐selectin, sP‐selectin, sICAM‐1, and IL‐8 in Pediatric Patients Treated for Psoriasis with the Goeckerman Regimen

Psoriasis is a chronic inflammatory skin disease which is often manifested during childhood. The present study investigated changes in the serum levels of proinflammatory cytokines and soluble forms of adhesion molecules in children with psoriasis. The observed patient group of 26 children was treated with the Goeckerman regimen. This therapy combines dermal application of crude coal tar with ultraviolet radiation. The Psoriasis Area Severity Index decreased significantly after treatment by with the Goeckerman regimen (p < 0.001). Serum levels of the proinflammatory cytokine TNF-alpha and adhesion molecules sICAM-1, sP-selectin and sE-selectin decreased after the Goeckerman regimen. The TNF-alpha and sICAM-1 decreased significantly (p < 0.05). Our findings support the complex role of these immune parameters in the immunopathogenesis of psoriasis in children. The serum level of IL-8 increased after the Goeckerman regimen. This fact indicates that the chemokine pathway of IL-8 activity could be modulated by this treatment, most likely by polycyclic aromatic hydrocarbons.

Genetic polymorphisms of adhesion molecules in children with severe RSV‐associated diseases

Adhesion molecules are involved in the pathophysiology of respiratory syncytial virus (RSV)-associated diseases. By testing polymorphisms within ICAM-1, VCAM-1 and E-selectin, we found no evidence for association of any polymorphism with severe RSV infections. Thus, we conclude that these genes do not predispose to severe RSV-associated diseases.

Oxidative stress and adhesion molecules in children with type 1 diabetes mellitus: a possible link

To examine whether oxidative stress parameters were correlated with adhesion molecules derived from endothelial/platelet activation in a group of juveniles with type 1 diabetes mellitus (T1DM). Indicative parameters of patient oxidant/antioxidant capacity were measured and associated with P-selectin and tetranectin (TN), markers of endothelial/platelet activation, in the plasma of 45 diabetic children and adolescents and 20 healthy age-matched subjects (HS). Significantly, higher nitrate/nitrite (NOx) and lipid hydroperoxide (LPO) levels (p=0.049 and p=0.0011, respectively), lower glutathione peroxidase activity (GPx; p=0.038), and elevated TN and P-selectin plasma levels (p=0.0046 and p=0.042, respectively) were found in T1DM children compared with HS. Well-controlled T1DM children (HbA1c <or= 7%) showed significantly lower GPx (p=0.0259), higher NOx and LPO (p=0.01093 and p=0.0092, respectively) compared with HS, while poorly controlled patients (HbA1c >7%) showed significantly higher TN, sP-selectin and LPO (p=0.0064, p=0.0234 and p=0.0121, respectively), a tendency to higher NOx (p=0.063) compared with HS and only TN higher (p=0.0123) compared with well-controlled patients. Patients with shorter diabetes duration (<or=3 yr) showed significantly higher LPO and TN (p=0.034 and 0.017, respectively), a tendency to higher NOx and lower GPx and higher P-selectin, while those with longer duration (>3 yr) differed significantly in all the examined parameters (TN, p=0.0015; GPx, p=0.0420; NOx, p=0.0196; LPO, p=0.0054; sP-selectin, p=0.0187) compared with HS. Decreased antioxidative protection from simultaneous LPO and NOx overproduction is evident in T1DM juveniles with a parallel endothelial/platelet activation even in the first years of the disease, being more pronounced later in diabetes progression, contributing to the vascular complications of the disease.

Effect of a Short-term Diet and Exercise Intervention on Serum Insulin, Lipids, Oxidative Stress, Inflammation, and Adhesion Molecules in Children

0539 Autopsy studies indicate that development of atherosclerosis begins as early as the first decade of life in humans. Consequently, lifestyle changes may mitigate the progression of atherogenesis early in life. PURPOSE: To determine the effects of a structured diet and exercise program on biomarkers that accompany the development of atherosclerosis in children and adolescents. METHODS: Boys and girls of varying levels of fitness and adiposity (n = 10, age 12.2 ± 1.9 years) were placed on a high- fiber, low-fat, low-cholesterol diet at the Pritikin 2-week residential program where food was provided ad libitum and daily aerobic exercise was performed. Fasting levels of insulin, 8-isoprostane PGF2α (8-iso-PGF2α), C-reactive protein (CRP), and E-selectin were determined by enzyme immunoassays. Additionally, fasting lipids were measured in serum using automated enzymatic procedures. RESULTS: After the 2-week program, significant reductions in total cholesterol (117 ± 5.6 vs. 164 ± 12 mg/dL, p<0.01), LDL (79.2 ± 6.9 vs. 124 ± 12 mg/dL, p<0.01), triglycerides (80.8 ± 11 vs. 141 ± 28 mg/dL, p<0.01), total cholesterol: HDL (3.24 ± 0.39 vs. 4.22 ± 0.39, p<0.01), CRP (1.90 ± 0.62 vs. 4.15 ± 1.1 mg/L, p<0.05), E-selectin (3.49 ± 0.21 vs. 4.65 ± 0.34 ng/mL, p<0.01), and 8-iso-PGF2α (3.15 ± 1.3 vs. 7.84 ± 2.2 pg/mL, p<0.05) were observed. Although insulin decreased 31% on average, this reduction did not achieve statistical significance (15.5 ± 1.9 vs. 22.6 ± 4.5 μU/mL, p = 0.1). No change in HDL was noted (38.2 ± 2.8 vs. 39.9 ± 2.3 mg/dL). A significant decrease in BMI (28.2 ± 2.8 vs. 29.7 ± 2.9 kg/m2, p<0.01) was also noted. CONCLUSION: A rigorous diet and exercise regimen can induce beneficial changes in risk factors for atherosclerosis, even in young individuals without documented atherosclerosis.

Effect of a Short-term Diet and Exercise Intervention on Serum Insulin, Lipids, Oxidative Stress, Inflammation, and Adhesion Molecules in Children

0539 Autopsy studies indicate that development of atherosclerosis begins as early as the first decade of life in humans. Consequently, lifestyle changes may mitigate the progression of atherogenesis early in life. PURPOSE: To determine the effects of a structured diet and exercise program on biomarkers that accompany the development of atherosclerosis in children and adolescents. METHODS: Boys and girls of varying levels of fitness and adiposity (n = 10, age 12.2 ± 1.9 years) were placed on a high- fiber, low-fat, low-cholesterol diet at the Pritikin 2-week residential program where food was provided ad libitum and daily aerobic exercise was performed. Fasting levels of insulin, 8-isoprostane PGF2α (8-iso-PGF2α), C-reactive protein (CRP), and E-selectin were determined by enzyme immunoassays. Additionally, fasting lipids were measured in serum using automated enzymatic procedures. RESULTS: After the 2-week program, significant reductions in total cholesterol (117 ± 5.6 vs. 164 ± 12 mg/dL, p<0.01), LDL (79.2 ± 6.9 vs. 124 ± 12 mg/dL, p<0.01), triglycerides (80.8 ± 11 vs. 141 ± 28 mg/dL, p<0.01), total cholesterol: HDL (3.24 ± 0.39 vs. 4.22 ± 0.39, p<0.01), CRP (1.90 ± 0.62 vs. 4.15 ± 1.1 mg/L, p<0.05), E-selectin (3.49 ± 0.21 vs. 4.65 ± 0.34 ng/mL, p<0.01), and 8-iso-PGF2α (3.15 ± 1.3 vs. 7.84 ± 2.2 pg/mL, p<0.05) were observed. Although insulin decreased 31% on average, this reduction did not achieve statistical significance (15.5 ± 1.9 vs. 22.6 ± 4.5 μU/mL, p = 0.1). No change in HDL was noted (38.2 ± 2.8 vs. 39.9 ± 2.3 mg/dL). A significant decrease in BMI (28.2 ± 2.8 vs. 29.7 ± 2.9 kg/m2, p<0.01) was also noted. CONCLUSION: A rigorous diet and exercise regimen can induce beneficial changes in risk factors for atherosclerosis, even in young individuals without documented atherosclerosis.

Soluble adhesion molecules in children and young adults on chronic hemodialysis.

Children on chronic hemodialysis (HD) present with impaired immunity that may result from disturbances in leukocyte migration, caused by changes in expression of adhesion molecules on endothelium and immunocompetent cells. However, it is still not clear whether the type of dialyzer or a single dialysis session influences the concentrations of soluble adhesion molecules in these patients. We evaluated by ELISA serum levels of soluble (s) VCAM-1, ICAM-1, L-selectin, and P-selectin in 22 patients on cuprophane HD (CU), 8 on polysulfone HD (PS), 10 on vitamin E-modified cellulose HD (VE), and 15 controls. In all HD patients, sVCAM-1 levels were elevated compared with controls and were higher in CU than in VE. The sICAM-1 concentrations were increased in VE compared with controls, but remained unchanged in CU and PS. The sL-selectin levels were reduced in all HD patients. The mean values of sP-selectin were comparable in CU, PS, and controls. The lowest levels were observed in VE. In CU patients, sVCAM-1, sICAM-1, and sP-selectin concentrations rose after HD. A single PS session had no impact on adhesion molecules, whereas a VE session increased the level of sVCAM-1. The type of dialysis membrane may change the profile of adhesion molecule concentrations, thus influencing the immune system of a child on HD. The increase in levels of adhesion molecules in the course of a single HD session, which was pronounced in CU and VE patients, suggests poor biocompatibility of these dialyzers.

Serum Levels of Adhesion Molecules in Children and Adolescents with Immune and Non-immune Thyroid Diseases

Serum levels of sICAM-1, sVCAM-1 and sP-selectin were determined in patients with Graves' disease before and after 8 weeks and 24 months of methimazole therapy, in levothyroxine suppressed patients with non-toxic nodular goiter, and in a group of healthy controls, to elucidate the relationship to circulating antithyroid antibodies and possible role of soluble adhesion molecules as markers of inflammatory activity. sICAM-1, sVCAM-1, and sP-selectin in patients with untreated hyperthyroidism were markedly elevated compared with controls. After 8 weeks of methimazole treatment, the concentrations of these molecules dropped, but were still significantly higher than in healthy children. In patients with clinical and biochemical remission after 24 months of therapy, sICAM-1 values were on the verge of significance, but still higher than in the control group, whereas serum levels of sVCAM-1 and sP-selectin had normalized. Slightly higher serum sICAM-1 values were observed in patients with non-toxic nodular goiter compared with healthy children.

Complement activation, cytokines, and adhesion molecules in children undergoing cardiac surgery with or without cardiopulmonary bypass.

The effect of cardiopulmonary bypass (CPB) on various blood parameters in children undergoing major cardiovascular surgery was investigated in a prospective clinical study. Blood samples of children with CPB (CPB group, n = 18) or without CPB (control, n = 12) were collected before, during, and after surgery. The concentration of routine laboratory parameters, components of the complement system (C3, C4, C5, C1 inhibitor, total hemolytic complement, C3d, and C5a), circulating interleukins (IL-6 and IL-8) and soluble adhesion molecules (sICAM-1 and sE-selectin) were determined. In both groups of patients the serum concentrations of C3, C4, C5, and C1 inhibitor were significantly affected by the treatments (p < 0.001), decreased immediately after onset of anesthesia, were minimal during surgery, and increased thereafter. No significant differences in the kinetics of these parameters were detectable between CPB and control group. In the CPB group the activation of the alternative pathway (increased C3d) was found to be a specific response (p = 0.005), but also in the control group C3d and C5a concentration increased significantly (p < 0.022), indicating complement activation. None of the effects that would be expected after activation of the complement system were specific for the CPB group. In both groups the serum levels of IL-6 increased dramatically during and/or after surgery (p = 0.001), and IL-8 was detectable after surgery in 10/12 control patients. The concentration of sICAM-1 and sE-selectin decreased during surgery (p < 0.04) and later did not increase above baseline. Our data suggest that increased serum levels of inflammation mediators and increased consumption of complement and adhesion molecules occur during cardiovascular surgery. Although complement activation and ICAM-1 consumption are more pronounced in the CPB patients, none of these changes occurs exclusively in the CPB group. We conclude, therefore, that these changes are the combined effect of anesthesia, surgical trauma, and endothelial lesions. Additional, undefined CPB-induced reactions may also contribute the postoperative morbidity.