title: Post-mortem markers of sepsis: an immunohistochemical study using VLA-4 (CD49d/CD29) and ICAM-1 (CD54) for the detection of sepsis-induced lung injury.
abstract: The up-regulation of different adhesion molecules such as VLA-4 (CD49d/CD29) and ICAM-1 (CD54) on the pulmonary endothelium and leukocytes, is a key event in sepsis-induced lung injury leading to inflammatory tissue alterations. The value of VLA-4 and ICAM-1 as micromorphological post-mortem markers for the detection of sepsis-induced lung injury, was evaluated in a semiquantitative immunohistochemical study. VLA-4 was strongly expressed on intravascular, interstitial and intra-alveolar leukocytes in sepsis-associated fatalities, whereas in non-septic fatalities an irregular weak immunoreactivity was observed on interstitial leukocytes and no positive immunohistochemical expression was detected on intravascular or intra-alveolar leukocytes. ICAM-1 was strongly expressed on endothelial cells of the pulmonary microvasculature and on pulmonary macrophages and lymphocytes in sepsis-associated fatalities. In contrast, an infrequent weak immunohistochemical reaction for ICAM-1 was found on pulmonary endothelium and on perivascular leukocytes in non-septic fatalities. Based on the results of the present preliminary study, VLA-4 and ICAM-1 can be considered as useful immunohistochemical post-mortem markers of sepsis.
authors.affiliation: Institute of Legal Medicine, University of Hamburg, Butenfeld 34, 22529 Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Tsokos
authors.forename: F
authors.initials: F
authors.lastname: Fehlauer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy / Q000379:methods*; D015415:Biomarkers; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D039041:Integrin alpha4beta1; D019012:Integrin beta1 / Q000378:metabolism*; D016023:Integrins / Q000378:metabolism*; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D016201:Receptors, Lymphocyte Homing / Q000378:metabolism*; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000378:metabolism; D018709:Statistics, Nonparametric; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications / Q000378:metabolism / Q000473:pathology*
chemical_list: D015415:Biomarkers; D015815:Cell Adhesion Molecules; D039041:Integrin alpha4beta1; D019012:Integrin beta1; D016023:Integrins; D016201:Receptors, Lymphocyte Homing; D018799:Intercellular Adhesion Molecule-1