Adhesion molecules in vernal keratoconjunctivitis.
OBJECTIVE
Adhesion molecules play a key role in the selective recruitment of different leucocyte population to inflammatory sites. The purpose of the present study was to investigate the presence and distribution of adhesion molecules in the conjunctiva of patients with vernal keratoconjunctivitis (VKC).


METHODS
The presence and distribution of adhesion molecules were studied in 14 conjunctival biopsy specimens from seven patients with active VKC and in four normal conjunctival biopsy specimens. We used a panel of specific monoclonal antibodies (mAbs) directed against intercellular adhesion molecule-1 (ICAM-1), intercellular adhesion molecule-3 (ICAM-3), lymphocyte function associated antigen-1 (LFA-1), very late activation antigen-4 (VLA-4), vascular cell adhesion molecule-1 (VCAM-1), and endothelial leucocyte adhesion molecule-1 (ELAM-1) In addition, a panel of mAbs were used to characterise the composition of the inflammatory infiltrate.


RESULTS
In the normal conjunctiva, ICAM-1 was expressed on the vascular endothelium only, LFA-1 and ICAM-3 on epithelial and stromal mononuclear cells, and VLA-4 on stromal mononuclear cells. The expression of VCAM-1 and ELAM-1 was absent. The number of cells expressing adhesion molecules was found to be markedly increased in all VKC specimens. This was concurrent with a heavy inflammatory infiltrate. Strong ICAM-1 expression was induced on the basal epithelial cells, and vascular endothelial cells. Furthermore, ICAM-I was expressed on stromal mononuclear cells. LFA-1 and ICAM-3 were expressed on the majority of epithelial and stromal infiltrating mononuclear cells. VLA-4 expression was noted on stromal mononuclear cells. Compared with controls, VKC specimens showed significantly more ICAM-3+, LFA-3+, LFA-1+, and VLA-4+ cells. VCAM-1 and ELAM-1 were induced on the vascular endothelial cells.


CONCLUSIONS
Increased expression of adhesion molecules may play an important role in the pathogenesis of VKC.
Abu el-Asrar
A M
AM
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Geboes
K
K
al-Kharashi
S
S
Tabbara
K F
KF
Missotten
L
L
Desmet
V
V
D000293:Adolescent; D015703:Antigens, CD; D000943:Antigens, Differentiation; D001706:Biopsy; D015815:Cell Adhesion Molecules / Q000378:metabolism*; D002648:Child; D003228:Conjunctiva / Q000378:metabolism*; D003233:Conjunctivitis, Allergic / Q000378:metabolism* / Q000473:pathology; D019040:E-Selectin / Q000378:metabolism; D006801:Humans; D007124:Immunoenzyme Techniques; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D016169:Lymphocyte Function-Associated Antigen-1 / Q000378:metabolism; D008297:Male; D019010:Vascular Cell Adhesion Molecule-1 / Q000378:metabolism
D015703:Antigens, CD; D000943:Antigens, Differentiation; D015815:Cell Adhesion Molecules; D019040:E-Selectin; C483616:ICAM3 protein, human; D016169:Lymphocyte Function-Associated Antigen-1; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1