title: Cell adhesion molecule expression in coronary artery aneurysms in acute Kawasaki disease.
abstract: BACKGROUND
  The pathogenesis of coronary artery aneurysm (CAA) formation in acute Kawasaki disease (KD) remains unclear. Cell adhesion molecules mediate cell-cell and cell-matrix interactions and regulate leukocyte migration, angiogenesis and tissue remodeling. We hypothesized that cell adhesion molecules are expressed in acute KD CAA.
  
  
  METHODS
  : P-selectin, E-selectin, vascular cell adhesion molecule-1 (VCAM-1) and integrin beta1 were immunolocalized in coronary arteries from 6 acute KD patients and 7 controls.
  
  
  RESULTS
  In endothelial cells of adventitial neovasculature in KD CAA, P-selectin and integrin beta1 were expressed in all of 6 patients, and E-selectin and/or VCAM-1 were expressed in 4 of 6. Endothelial cells in controls and in nonaneurysmal KD coronary arteries expressed P-selectin and integrin beta1, but not E-selectin or VCAM-1. Integrin beta1 was expressed on infiltrating leukocytes in 5 of 6 KD CAA and on fibroblasts in 6 of 6; these findings were absent in controls and in nonaneurysmal KD coronary arteries.
  
  
  CONCLUSIONS
  The lack of widespread expression of E-selectin or VCAM-1 on endothelial cells of acute KD coronary arteries was surprising and suggests that inflammatory cell infiltration into KD coronaries is not simply the result of widespread up-regulation of cell adhesion molecules on endothelial cells by circulating cytokines. Rather, inflammatory cells may be directed to specific areas of the coronary arteries targeted by a pathogen causing KD. Our results suggest that E-selectin and VCAM-1 expression on neovasculature may contribute to neoangiogenesis and prolonged CAA inflammation and that integrin beta1 might be involved in fibroblastic remodeling of acute KD CAA.
authors.affiliation: Department of Pediatrics, Northwestern University, The Feinberg School of Medicine and The Children's Memorial Hospital, Chicago, IL, USA.
authors.forename: Masaru
authors.initials: M
authors.lastname: Miura
authors.forename: Francesca L
authors.initials: FL
authors.lastname: Garcia
authors.forename: Susan E
authors.initials: SE
authors.lastname: Crawford
authors.forename: Anne H
authors.initials: AH
authors.lastname: Rowley
mesh_terms: D000293:Adolescent; D015815:Cell Adhesion Molecules / Q000032:analysis*; D002648:Child; D003323:Coronary Aneurysm / Q000209:etiology / Q000378:metabolism* / Q000473:pathology; D003331:Coronary Vessels / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D013194:Staining and Labeling
chemical_list: D015815:Cell Adhesion Molecules