Differential expression of cell adhesion molecules in inflamed appendix: correlation with clinical stage.
The diagnosis of 'early inflamed', 'recurrent' or 'sub-acute' appendicitis is often difficult and accompanied by controversies between clinical data, histological findings, and their interpretation. The expression of the intercellular cell adhesion molecule-1 (ICAM-1), the vascular cell adhesion molecule-1 (VCAM-1), and E-selectin has been studied in 61 appendicectomy specimens for possible use as a diagnostic tool. This study demonstrates a different expression of CAM by endothelial (EC) and mesothelial cells (MC) in the various stages of appendicitis, with early E-selectin and ICAM-1 expression in EC, followed by VCAM-1 in EC and MC. Appendices from patients with prolonged clinical symptoms defined by clinicians as 'chronic' appendicitis showed VCAM-1 expression and occasionally weak expression of E-selectin in EC. In several cases, discrepancies were found between the pre-operative 'clinical' diagnosis, the histomorphological findings, and the immunohistological results. In this context, the expression of E-selectin and VCAM-1 in comparison with the histological features has potential significance in the diagnosis of 'early acute', 'sub-acute' or 'recurrent' appendicitis. In addition, a correlation was demonstrated between the histological stages of appendicitis and the kinetics of CAM expression. The study also indicates that the time course of E-selectin expression in vivo is longer than is suggested from in vitro data.
Bittinger
F
F
Institute of Pathology, Johannes Gutenberg University, Mainz, Germany.
Brochhausen
C
C
Köhler
H
H
Lehr
H A
HA
Otto
M
M
Skarke
C
C
Walgenbach
S
S
Kirkpatrick
C J
CJ
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy; D001064:Appendicitis / Q000378:metabolism* / Q000473:pathology; D015815:Cell Adhesion Molecules / Q000378:metabolism*; D002908:Chronic Disease; D019040:E-Selectin / Q000378:metabolism; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D019010:Vascular Cell Adhesion Molecule-1 / Q000378:metabolism
D015815:Cell Adhesion Molecules; D019040:E-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1