Leukocyte extravasation from the blood across the endothelium is vital for
the functioning of the immune system. Our understanding of the early steps
of this process has developed rapidly. However, it is still unclear how leu
kocytes undergo the final step, migrating through the junctions that mediat
e adhesion between adjacent endothelial cells, while preserving the barrier
function of the endothelium. The first stage of transmigration - tethering
and rolling - is mediated by interactions between selectins on the surface
of leukocytes and glycosylated proteins such as GLyCAM-1 on the surface of
endothelial cells. Stimulation of the leukocyte by chemokines then induces
tight adhesion, which involves binding of activated leukocyte integrins to
endothelial ICAM-1/VCAM-1 molecules. Passage of the leukocyte across the e
ndothelium appears to require delocalization of certain endothelial cell mo
lecules and proteolytic degradation of junctional complexes.