89392
document
Soluble intercellular adhesion molecule-1 in primary biliary cirrhosis : effect of ursodeoxycholic acid and immunosuppressive therapy . OBJECTIVES Soluble intercellular adhesion molecule-1 ( sICAM-1 ) is thought to be released by a variety of cells at sites of inflammation , and their serum levels have been used as markers of inflammatory and immune activity . Our aim was to determine the effect of therapy with ursodeoxycholic acid alone and in combination with azathioprine and prednisone on serum sICAM-1 levels in primary biliary cirrhosis . DESIGN/METHODS Twenty-four patients with primary biliary cirrhosis and 17 healthy subjects were studied . Primary biliary cirrhosis patients received ursodeoxycholic acid for 12 months and were then randomized in a double-blind fashion to receive prednisone and azathioprine , or placebo in addition to ursodeoxycholic acid . RESULTS sICAM-1 levels were significantly higher in primary biliary cirrhosis patients than healthy subjects and fell by a median of 20 % after 12 months ' therapy with ursodeoxycholic acid ( P < 0.0004 ) . Addition of azathioprine and prednisone to ursodeoxycholic acid resulted in a further reduction of sICAM-1 levels by a median of 25 % ( P < 0.01 ) . Reductions in sICAM-1 were accompanied by improvement in liver function tests but not in the lymphocyte activation marker , soluble interleukin-2 receptor . CONCLUSION sICAM-1 levels in primary biliary cirrhosis are reduced by ursodeoxycholic acid . Further reductions were achieved by adding prednisone and azathioprine . These reductions probably reflect an improvement in hepatobiliary excretion and a reduction in cellular production of sICAM-1 .
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Intervention_Pharmacological
ursodeoxycholic acid
89394
Intervention_Pharmacological
immunosuppressive therapy
89395
Intervention_Pharmacological
ursodeoxycholic acid alone
89396
Intervention_Pharmacological
azathioprine and prednisone
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Intervention_Pharmacological
ursodeoxycholic acid
89398
Intervention_Pharmacological
prednisone
89399
Intervention_Pharmacological
azathioprine
89400
Intervention_Control
placebo
89401
Intervention_Pharmacological
ursodeoxycholic acid
89402
Intervention_Pharmacological
ursodeoxycholic acid
89403
Intervention_Pharmacological
azathioprine
89404
Intervention_Pharmacological
prednisone
89405
Intervention_Pharmacological
ursodeoxycholic acid
89406
Intervention_Pharmacological
ursodeoxycholic acid
89407
Intervention_Pharmacological
prednisone
89408
Intervention_Pharmacological
azathioprine
89409
Outcome_Physical
serum sICAM-1 levels
89410
Outcome_Physical
sICAM-1 levels
89411
Outcome_Physical
sICAM-1 levels
89412
Outcome_Physical
sICAM-1
89413
Outcome_Physical
liver function tests
89414
Outcome_Physical
lymphocyte activation marker
89415
Outcome_Physical
soluble interleukin-2 receptor
89416
Outcome_Physical
sICAM-1 levels
89417
Outcome_Physical
hepatobiliary excretion
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Outcome_Physical
cellular production of sICAM-1
89419
Participant_Condition
primary biliary cirrhosis :
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Participant_Sample-size
Twenty-four
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Participant_Condition
primary biliary cirrhosis
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Participant_Condition
healthy subjects