Norton J, Sloane J P
Department of Histopathology, Royal Marsden Hospital, Sutton, Surrey, United Kingdom.
Transplantation. 1991 Jun;51(6):1203-6. doi: 10.1097/00007890-199106000-00011.
An immunohistological study of epidermal keratinocytes for the intercellular adhesion molecule, ICAM-1 (CD54), was undertaken on skin biopsies from allogeneic bone marrow transplant recipients. In control biopsies from normal donors and patients prior to transplantation, staining was weak and confined to relatively few cells. After transplantation there was a significant increase in both the number of positive cells and their staining intensity in biopsies showing histological evidence of GVHD but not in those exhibiting normal appearances or epidermal abnormalities that could be attributed to cytotoxic drugs or irradiation. There was a strong positive correlation between ICAM-1 and HLA-DR expression by keratinocytes. All cases exhibiting increased ICAM-1 also exhibited an increase in HLA-DR antigens. The converse was not true, however, as 6 biopsies exhibited HLA-DR positivity without detectable increases in ICAM-1. Both ICAM-1 and HLA-DR antigen synthesis may be stimulated by local cytokine release following interactions between donor and recipient cells in the early posttransplant period. Our present findings suggest that immunostaining for ICAM-1 has little value in the early diagnosis of cutaneous GVHD but further, more detailed prospective studies would be of value.
对异基因骨髓移植受者的皮肤活检标本进行了表皮角质形成细胞细胞间黏附分子ICAM-1（CD54）的免疫组织学研究。在来自正常供体和移植前患者的对照活检标本中，染色较弱且局限于相对较少的细胞。移植后，在显示移植物抗宿主病（GVHD）组织学证据的活检标本中，阳性细胞数量及其染色强度均显著增加，但在那些表现正常外观或可归因于细胞毒性药物或辐射的表皮异常的活检标本中则没有增加。角质形成细胞的ICAM-1与HLA-DR表达之间存在强正相关。所有ICAM-1增加的病例HLA-DR抗原也增加。然而，反之则不然，因为有6份活检标本显示HLA-DR阳性而ICAM-1未检测到增加。移植后早期供体和受体细胞相互作用后局部细胞因子释放可能刺激ICAM-1和HLA-DR抗原的合成。我们目前的研究结果表明，ICAM-1免疫染色在皮肤GVHD的早期诊断中价值不大，但进一步更详细的前瞻性研究将是有价值的。
