Vascular endothelial cell distribution and adhesion molecule expression in xanthoma.
BACKGROUND
The migration of circulating monocytes into the dermis is considered to be essential for both the initiation and the progression of xanthoma. The contribution of vascular endothelial cells to the migration process is unclear.


METHODS
Twenty cases of xanthelasma and six cases of tuberous xanthoma lesions were analyzed using immunohistochemical staining.


RESULTS
Xanthoma lesions contained up to 25-fold more von Willebrand factor-stained endothelial cells than normal skin. The prevalence of E-selectin-positive endothelial cells increased by up to threefold more in xanthoma lesions than in normal skin. In contrast, the prevalence of intercellular cell adhesion molecule-1 (ICAM-1) decreased up to 3.5-fold more in xanthoma lesions than in normal skin. In xanthoma lesions, almost all ICAM-1-positive endothelial cells co-expressed with E-selectin but many endothelial cells, which only expressed E-selectin, were also found in the lesions and the ratio of macrophages to endothelial cells was higher (10:1) than that in normal skin (5:1).


CONCLUSIONS
Endothelial cells proliferate and express E-selectin rather than ICAM-1 under a microenvironment in which macrophages predominate rather than endothelial cells, thereby promoting macrophage migration into xanthoma lesions.
Matsumoto
Masaaki
M
Department of Dermatology, Kochi Medical School, Okohcho, Nankoku, Kochi, Japan. matsumo@kochu-u.ac.jp
Kunimitsu
Sawa
S
Wada
Kana
K
Ikeda
Mitsunori
M
Yokogawa
Maki
M
Keyama
Akira
A
Kodama
Hajime
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D015815:Cell Adhesion Molecules / Q000378:metabolism*; D002452:Cell Count; D002465:Cell Movement; D020405:Dermis / Q000378:metabolism / Q000473:pathology; D019040:E-Selectin / Q000378:metabolism; D042783:Endothelial Cells / Q000378:metabolism / Q000473:pathology*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007124:Immunoenzyme Techniques; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D008264:Macrophages; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000378:metabolism / Q000473:pathology*; D019010:Vascular Cell Adhesion Molecule-1 / Q000378:metabolism; D014973:Xanthomatosis / Q000378:metabolism / Q000473:pathology*; D014841:von Willebrand Factor / Q000378:metabolism
D015415:Biomarkers; D015815:Cell Adhesion Molecules; D019040:E-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D014841:von Willebrand Factor; D018799:Intercellular Adhesion Molecule-1