Jones S C, Banks R E, Haidar A, Gearing A J, Hemingway I K, Ibbotson S H, Dixon M F, Axon A T
Centre for Digestive Diseases, General Infirmary, Leeds.
Gut. 1995 May;36(5):724-30. doi: 10.1136/gut.36.5.724.
The ability of leucocytes to adhere to endothelium is essential for leucocyte migration into inflammatory sites. Some of these adhesion molecules are released from the cell surface and can be detected in serum. The soluble adhesion molecules intercellular adhesion molecule 1 (ICAM-1), E selectin, and vascular cell adhesion molecule 1 (VCAM-1) were studied in the serum of patients with Crohn's disease, ulcerative colitis, and healthy controls. A second blood sample was taken from patients with active disease after one month of treatment and a third two months after remission was achieved. Tissue expression of the same adhesion molecules was studied by immunohistology. Circulating VCAM-1 concentrations were significantly higher in patients with active ulcerative colitis (n = 11, median = 165 U/ml) compared with patients with inactive ulcerative colitis (n = 10, median = 117 U/ml, p < 0.005), active Crohn's disease (n = 12, median = 124 U/ml, p < 0.02), and controls (n = 90, median = 50 U/ml, p < 0.0001). Within each disease group there were no significant differences in E selectin or ICAM-1 concentrations between the active and inactive states, however, patients with active Crohn's disease had significantly higher ICAM-1 concentrations (n = 12, median = 273 ng/ml) than controls (n = 28, median = 168, p < 0.003). VCAM-1 concentrations fell significantly from pretreatment values to remission in active ulcerative colitis (p < 0.01). In Crohn's disease there was a significant fall in ICAM-1 both during treatment (p < 0.01) and two months after remission (p < 0.02). Vascular expression of ICAM-1 occurred more often and was more intense in inflamed tissue sections from patients with ulcerative colitis and Crohn's disease than from controls. Vascular labelling with antibody to E selectin also occurred more often in patients with active inflammatory bowel disease. In conclusion, increased circulating concentrations of selected adhesion molecules are associated with inflammatory bowel disease. There is also evidence of local upregulation, particularly of ICAM-1. Differential expression of adhesion molecules in tissue may play a part in the initiation of leucocyte migration and local inflammation; the function of circulating adhesion molecules is unknown, but may play a physiological part in blocking adhesion.
白细胞黏附于内皮细胞的能力对于白细胞迁移至炎症部位至关重要。其中一些黏附分子从细胞表面释放，可在血清中检测到。对克罗恩病、溃疡性结肠炎患者及健康对照者血清中的可溶性黏附分子细胞间黏附分子1（ICAM - 1）、E选择素和血管细胞黏附分子1（VCAM - 1）进行了研究。对处于活动期的患者在治疗1个月后采集第二份血样，在病情缓解2个月后采集第三份血样。通过免疫组织学研究相同黏附分子的组织表达情况。与非活动期溃疡性结肠炎患者（n = 10，中位数 = 117 U/ml，p < 0.005）、活动期克罗恩病患者（n = 12，中位数 = 124 U/ml，p < 0.02）及对照组（n = 90，中位数 = 50 U/ml，p < 0.0001）相比，活动期溃疡性结肠炎患者（n = 11，中位数 = 165 U/ml）循环中的VCAM - 1浓度显著更高。在每个疾病组中，活动期和非活动期之间E选择素或ICAM - 1浓度无显著差异，然而，活动期克罗恩病患者（n = 12，中位数 = 273 ng/ml）的ICAM - 1浓度显著高于对照组（n = 28，中位数 = 168，p < 0.003）。在活动期溃疡性结肠炎中，VCAM - 1浓度从治疗前值降至缓解期时显著下降（p < 0.01）。在克罗恩病中，ICAM - 1在治疗期间（p < 0.01）及缓解后2个月（p < 0.02）均显著下降。与对照组相比，溃疡性结肠炎和克罗恩病患者炎症组织切片中ICAM - 1的血管表达更频繁且更强烈。用抗E选择素抗体进行血管标记在活动期炎症性肠病患者中也更常见。总之，特定黏附分子循环浓度升高与炎症性肠病相关。也有局部上调的证据，尤其是ICAM - 1。黏附分子在组织中的差异表达可能在白细胞迁移和局部炎症的起始过程中起作用；循环黏附分子的功能尚不清楚，但可能在阻断黏附中发挥生理作用。
