Cell adhesion molecules: a unifying approach to topographic biology

Cell adhesion molecules are pivotal to the development and maintenance of tissue structure in metazoan organisms. In mammals, several families of proteins are involved in cell-cell and cell-matrix adhesion. The cadherins are homophilic, primary CAMs, involved in the establishment of boundaries between cell collectives early in embryogenesis. The Ig gene superfamily have diversified widely, with homophilic and heterophilic CAMs and antigen recognition molecules amongst the members. The Integrin family play an important role in binding to extracellular matrix, as well as counter-receptors on the surface of other cells. The Selectin family and HCAM are carbohydrate-binding proteins, and play a prominent role in the circulation of lymphocytes and neoplastic cells. CAMs are fundamental to development of tissue structure in metazoan organisms. Cellular differentiation dictates adherence to a specific microenvironment, through the pattern of surface CAM expression. Conversely, CAM binding can affect gene expression within the cell itself. Cell differentiation and cell adhesion are interdependent processes. In the adult, CAM are crucial to tissue maintenance. Cells frequently change their adhesive properties in response to physiological or pathological processes. The integrity of the vascular system is maintained by circulating platelets which are capable of rapid upregulation of cell adhesion and profound changes in metabolism, on contact with subendothelial matrix. Both endothelial cells and neutrophils undergo changes in CAM expression in response to inflammatory mediators, permitting rapid and appropriate recruitment of phagocytes to damaged tissue. Tissue repair is dependent on phenotypic changes in normally static cells, allowing increased motility and replication. The immune system requires constitutive cells to undergo multiple complex adhesion and detachment events over short periods of time, and is capable of discriminating normal self from aberrant-self or non-self, through antigen specific recognition and adhesion molecules. The pathophysiology of processes such as infection and neoplasia are profoundly affected by cellular CAM expression. CAMs and related molecules are fundamental to the development, maintenance and surveillance of tissue structure.