Norton J, Sloane J P, al-Saffar N, Haskard D O
Department of Histopathology, Royal Marsden Hospital, Sutton, Surrey, UK.
Clin Exp Immunol. 1992 Feb;87(2):231-6. doi: 10.1111/j.1365-2249.1992.tb02980.x.
The distribution of three cellular adhesion molecules, ICAM-1, ELAM-1 and VCAM-1, was studied in normal rectal mucosa and in graft-versus-host disease (GvHD) using immunohistological and morphometric techniques. In normal controls, ICAM-1 was demonstrable on endothelial cells and leucocytes within the lamina propria, ELAM-1 on endothelial cells only and VCAM-1 on lamina propria leucocytes, many of which exhibited long dendritic processes surrounding the glands. In GvHD, the enterocytes became positive for ICAM-1 and this was often associated with the presence of intra-epithelial LFA-1+ lymphocytes and macrophages, the latter containing debris of apoptotic cells. The staining was, however, restricted to the luminal membrane of the epithelial cells, raising doubts about the role of ICAM-1 as a ligand for LFA-1 on mucosal leucocytes in rectal GvHD. ELAM-1 expression was increased in GvHD both in terms of the length of positive endothelium and staining intensity. VACM-1 was increased on endothelial cells but not leucocytes in the lamina propria in contrast to our previous findings in cutaneous GvHD where VCAM-1+ dendritic cells were increased and endothelial cells remained negative. Normal patterns of adhesion molecule staining were seen in two biopsies exhibiting no morphological evidence of GvHD, from patients who had strong clinical evidence of the disease, indicating that immunostaining for these molecules is unlikely to be of help in improving the sensitivity of histological diagnosis. However, the possibility that adhesion molecule staining may be useful in improving diagnostic specificity by helping to distinguish GvHD from identical histological changes produced by irradiation and cytotoxic drugs is worthy of further investigation.
采用免疫组织学和形态计量学技术，研究了三种细胞黏附分子ICAM-1、ELAM-1和VCAM-1在正常直肠黏膜和移植物抗宿主病（GvHD）中的分布。在正常对照组中，ICAM-1在固有层内的内皮细胞和白细胞上可检测到，ELAM-1仅在内皮细胞上，VCAM-1在固有层白细胞上，其中许多白细胞表现出围绕腺体的长树突状突起。在GvHD中，肠上皮细胞对ICAM-1呈阳性，这通常与上皮内LFA-1+淋巴细胞和巨噬细胞的存在有关，后者含有凋亡细胞的碎片。然而，染色仅限于上皮细胞的腔面膜，这使人对ICAM-1作为直肠GvHD中黏膜白细胞上LFA-1的配体的作用产生怀疑。在GvHD中，ELAM-1的表达在阳性内皮长度和染色强度方面均增加。与我们之前在皮肤GvHD中的发现相反，在GvHD中，固有层内皮细胞上的VACM-1增加，而白细胞上没有增加，在皮肤GvHD中，VCAM-1+树突状细胞增加，内皮细胞保持阴性。在两名活检中未见GvHD形态学证据的患者中，观察到黏附分子染色的正常模式，这些患者有该疾病的强烈临床证据，表明对这些分子进行免疫染色不太可能有助于提高组织学诊断的敏感性。然而，黏附分子染色可能有助于将GvHD与放疗和细胞毒性药物产生的相同组织学变化区分开来，从而提高诊断特异性，这一可能性值得进一步研究。
