Circulating Adhesion Molecules and Subclinical Interstitial Lung Disease: The Multi-Ethnic Study of Atherosclerosis

Adhesion molecules may contribute to the development of interstitial lung disease (ILD) and have been proposed as prognostic biomarkers in idiopathic pulmonary fibrosis. Our objective was to determine whether circulating adhesion molecules sICAM-1, sVCAM-1 and P-selectin are associated with subclinical ILD in community-dwelling adults. The Multi-Ethnic Study of Atherosclerosis enrolled men and women aged 45–84 from six communities in the United States in 2000–2002. High attenuation areas were defined as the percentage of imaged lung volume with attenuation −600 to −250 Hounsfield Units on cardiac computed tomography. Interstitial lung abnormalities (ILA) were visually assessed on a full lung computed tomography. Spirometry was performed on a subset of individuals. ILD hospitalisations and deaths were adjudicated. In fully adjusted analyses, higher levels of sICAM-1, sVCAM-1 and P-selectin were associated with greater high attenuation areas (2.94%, 95%CI 1.80–4.07; 1.24%, 95%CI 0.14–2.35; 1.58%, 95%CI 0.92–2.23, respectively), and greater rate of ILD hospitalisations (HR 1.36, 95%CI 1.03–1.80; 1.40, 95%CI 1.07–1.85, 2.03, 95%CI 1.16–3.5, respectively). sICAM-1 was associated with greater prevalence of interstitial lung abnormalities (OR 1.39, 95%CI 1.13–1.71). sICAM-1 and P-selectin were associated with lower forced vital capacity (44 mL, 95%CI 12–76; 29 mL, 95%CI 8–49, respectively). sVCAM-1 and P-selectin were associated with increased risk of ILD death (HR 2.15, 95%CI 1.26–3.64; 3.61, 95%CI 1.54–8.46, respectively). Higher levels of circulating sICAM-1, sVCAM-1, and P-selectin are independently associated with CT and spirometric measures of subclinical ILD, and increased rate of adjudicated ILD events among community-dwelling adults.