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ICAM-1 expression on epidermal keratinocytes in cutaneous graft-versus-host disease
1Department of Histopathology, Royal Marsden Hospital, Sutton, Surrey, United Kingdom.
Insights
Immunohistological study shows increased intercellular adhesion molecule-1 (ICAM-1) in skin biopsies of bone marrow transplant patients with graft-versus-host disease (GVHD). ICAM-1 expression correlates with HLA-DR, but is not a reliable early diagnostic marker for cutaneous GVHD.
Area of Science:
- Immunology
- Dermatology
- Transplantation Biology
Background:
- Graft-versus-host disease (GVHD) is a major complication following allogeneic bone marrow transplantation.
- Intercellular adhesion molecule-1 (ICAM-1) plays a role in immune cell adhesion and trafficking.
- Understanding the expression of adhesion molecules like ICAM-1 in GVHD is crucial for diagnosis and management.
Purpose of the Study:
- To investigate the expression of ICAM-1 in epidermal keratinocytes of allogeneic bone marrow transplant recipients.
- To correlate ICAM-1 expression with histological findings of GVHD and other post-transplant changes.
- To assess the potential diagnostic value of ICAM-1 immunostaining in early cutaneous GVHD.
Main Methods:
- Skin biopsies were obtained from allogeneic bone marrow transplant recipients.
- Immunohistological staining was performed to detect ICAM-1 (CD54) expression in epidermal keratinocytes.
- Biopsies were analyzed for histological evidence of GVHD, normal appearance, or drug/irradiation-induced abnormalities.
- Expression levels of ICAM-1 and HLA-DR were quantified and correlated.
Main Results:
- ICAM-1 expression was significantly increased in biopsies with histological evidence of GVHD compared to controls.
- Increased ICAM-1 staining intensity and the number of positive cells were observed in GVHD cases.
- A strong positive correlation was found between ICAM-1 and HLA-DR expression on keratinocytes.
- HLA-DR expression was observed in some cases without increased ICAM-1, suggesting differential regulation.
Conclusions:
- ICAM-1 expression is upregulated in the epidermis during cutaneous GVHD following allogeneic bone marrow transplantation.
- The co-expression of ICAM-1 and HLA-DR suggests a role for local cytokine release in their induction.
- Immunostaining for ICAM-1 alone has limited value for the early diagnosis of cutaneous GVHD.
- Further prospective studies are warranted to fully elucidate the role of ICAM-1 in GVHD pathogenesis and diagnosis.
Abstract:
An immunohistological study of epidermal keratinocytes for the intercellular adhesion molecule, ICAM-1 (CD54), was undertaken on skin biopsies from allogeneic bone marrow transplant recipients. In control biopsies from normal donors and patients prior to transplantation, staining was weak and confined to relatively few cells. After transplantation there was a significant increase in both the number of positive cells and their staining intensity in biopsies showing histological evidence of GVHD but not in those exhibiting normal appearances or epidermal abnormalities that could be attributed to cytotoxic drugs or irradiation. There was a strong positive correlation between ICAM-1 and HLA-DR expression by keratinocytes. All cases exhibiting increased ICAM-1 also exhibited an increase in HLA-DR antigens. The converse was not true, however, as 6 biopsies exhibited HLA-DR positivity without detectable increases in ICAM-1. Both ICAM-1 and HLA-DR antigen synthesis may be stimulated by local cytokine release following interactions between donor and recipient cells in the early posttransplant period. Our present findings suggest that immunostaining for ICAM-1 has little value in the early diagnosis of cutaneous GVHD but further, more detailed prospective studies would be of value.