[The influence of adhesion molecules in inflammatory bowel diseases]

Cell adhesion molecules are a group of membrane-bound molecules that are involved in the binding of circulating leukocytes to activated endothelial cells and in the migration of these leukocytes towards the inflamed area. Cellular adhesion molecules are divided into four major families: selectins, immunoglobulin-like cell adhesion molecules, integrins, and carbohydrate ligands. Selectins (E-, P-, and L-) and their ligands, ICAM-1, VCAM-1, VLA-4, beta 2 integrins, and presumably also PECAM-1, MAdCAM-1, and alpha 4 beta 2 have been shown to be central in the development of the anatomic lesions in ulcerative colitis and Crohn's disease. Even though investigations on the effect of antibodies against cellular adhesion molecules in relation to inflammatory bowel disease are limited, an anti-inflammatory effect may be possible. Drugs which interfere with the function of cellular adhesion molecules should be tested in trials, as it only by this way can be determined whether they are beneficial and appropriate. At present, however, it is known that glucocorticoids and 5-aminosalicylic acid, which are the cornerstones in inflammatory bowel disease treatment, both interact with the synthesis and function of cellular adhesion molecules.