EXPRESSION OF ADHESION MOLECULES IN ENDOTHELIAL-CELLS DURING ALLOGENEIC BONE-MARROW TRANSPLANTATION

Endothelial cell activation during allogeneic bone marrow transplantat ion, mainly in acute graft-versus-host disease (aGvHD) was studied in 23 recipients and 5 controls using anti-von Willebrand factor (VWF) an tibody, antibodies to endothelial leukocyte adhesion molecule-1 (ELAM- 1), vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhes ion molecule-1 (ICAM-1), and anti-HLA-DQ antibody, by immunohistologic al staining of skin. VWF extravasation, ELAM-1 and VCAM-1 expression w ere present in most recipients with a cutaneous rash which was confirm ed as an aGvHD by histological examination (documented aGvHD) (p = 0.0 05 for VWF extravasation and ELAM-1 expression and p = 0.03 for VCAM-1 expression in comparison with the controls). In recipients with a ras h, the cases displaying vWF extravasation and ELAM-1 expression were s ignificantly more numerous in those with a documented aGvHD than in th ose without histological features of aGvHD (p = 0.01). VWF extravasati on and ELAM-1 occurred concomitantly (p < 0.01). This study demonstrat es that, during the course of skin aGvHD following bone marrow transpl antation, there is transient expression of ELAM-1 and VCAM-1 by endoth elial cells and simultaneous VWF extravasation, indicating an intense inflammation with endothelial cell participation.