CELL-ADHESION MOLECULES IN CLINICAL RENAL-TRANSPLANTATION

Leukocyte adhesion molecules are critically involved at a number of st ages in immune and inflammatory responses, and their importance in the response to a renal allograft has been recognized for some years, The y are involved in antigen presentation, in the cascade of events leadi ng to extravasation of leukocytes into the allograft, in the subsequen t migration of leukocytes through the extracellular matrix, and in the interactions between effector and target cells. Thus the adhesion mol ecules are highly attractive targets far therapeutic intervention in o rgan transplantation. Strategies have been explored to exploit the inv olvement of adhesion molecules in ischemia/reperfusion injury, allogra ft rejection, and the induction of immunological tolerance, Furthermor e, the expression of a number of adhesion molecules is regulated by cy tokines, and elevated levels may be detected both in transplant biopsi es and as soluble forms measured in serum and urine, It has been propo sed that these changes in levels might provide useful information in t he diagnosis of allograft rejection and differentiation from other cau ses of graft dysfunction.