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Leukocyte-endothelium interactions in cutaneous inflammatory processes

Conclusions

It is over 100 years since an active role for vascular endothelium was first established in leukocyte localisation to sites of inflammation. A critical part of this process is now known to be mediated via adhesion interactions between receptors on circulating leukocytes and their ligands, particularly ELAM-1, VCAM-1 and ICAM-1 induced on activated endothelium, allowing leukocytes to “roll”, “arrest” and subsequently undergo “diapedesis” through the vessel wall towards the inflammatory focus.

There is increasing evidence linking such mechanisms to leukocyte recruitment into inflamed skin. Intradermal injections of pro-inflammatory cytokines (IL-1, TNF-α, IFN-γ) directly induce dermal vascular endothelium adhesion molecule expression which is parallelled by accumulation of a dermal inflammatory cell infiltrate. In experimentally induced cutaneous inflammation, e. g. ACD and UVB radiation exposure, up-regulation of vascular endothlial ICAM-1, VCAM-1 and ELAM-1 expression is observed. Alterations in adhesion both at the phenotypic and functional level are also observed in many other disorders including the inflammatory dermatoses for example psoriasis, lichen planus and atopic dermatitis.

Adhesion molecule expression by endothelium requires activation of these cells by soluble inflammatory mediators including peptides (cytokines), lipid mediators and complement factors. Important constituents of normal human skin that may contribute to this process include fibroblasts, mast cells, dermal dendrocytes and epidermal keratinocytes. The relative role fo each cell type and mediator is likely to depend upon the underlying pathophysiology of the disease or the source and type of the initiating agent.

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Correspondence to Jonathan N. W. N. Barker.

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Barker, J.N.W.N., Nickoloff, B.J. Leukocyte-endothelium interactions in cutaneous inflammatory processes. Springer Semin Immunopathol 13, 355–367 (1992). https://doi.org/10.1007/BF00200534

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Keywords

  • Psoriasis
  • Atopic Dermatitis
  • Lichen Planus
  • Adhesion Molecule Expression
  • Inflammatory Cell Infiltrate