Adhesion molecule expression in erythema nodosum-like lesions in Behçet's disease

Abstract

Behçet's (BD) is a systemic inflammatory disease with histological evidence for vasculitis. Leucocyte-leucocyte and leucocyte-endothelial cell interactions are critical in inflammatory reactions that are influenced by the expression, activation and shedding of adhesion molecules. We investigated the expression of some adhesion molecules (E- and L-selectin, VLA-4, ICAM-1, PECAM-1, VCAM-1 and CD18 and CD11c chains of beta-2 integrins) on endothelial and inflammatory cells by immunohistochemistry on cryostat sections of erythema nodosum lesions taken from 15 patients with BD and 12 patients with erythema nodosum of unknown cause. Hematoxylin-eosin stained sections of all specimens were also assessed. The major histopathological findings were perivascular mononuclear cell infiltration and secondary vasculitic changes with no difference between the two groups (P > 0.05). However, the frequency of thrombophlebitis was higher in BD (P < 0.001). Endothelial and inflammatory cell adhesion molecule expression did not show any significant difference between groups (P > 0.05). Although VCAM-1 expression and intensity on endothelial cells of BD patients seemed to be lower, this did not reach statistical significance (P = 0.056). We concluded that subcutaneous thrombophlebitis is an important feature of erythema nodosum like lesions in BD, which is almost impossible to understand by physical examination alone. Colchicine, which is known to have some influence on adhesion molecules, might have affected our results, as these showed no significant difference regarding adhesion molecules between the two groups.

The significance of immunohistochemistry in the skin pathergy reaction of patients with Behçet's syndrome

“…In addition, serum levels of E‐selectin were prominently increased during the active stage of the disease, indicating the presence of immune system activation and endothelial injury in Behçet's syndrome 13 . Furthermore, the expression of E‐ and L ‐selectin on the endothelial and inflammatory cells by immunohistochemistry in erythema nodosum lesions taken from 15 patients with Behçet's syndrome has been demonstrated previously 14 . Because leucocyte–leucocyte and leucocyte–endothelial cell interactions are critical in the inflammatory reactions that are influenced by the expression, activation and shedding of adhesion molecules in Behçet's syndrome, we investigated the immunostaining of these adhesion molecules (E‐ and L ‐selectin, and endoglin) in such patients with or without positive SPR.…”

Erythema nodosum and erythema induratum (nodular vasculitis): diagnosis and management

“…Histopathologically, EN is the prototypical septal panniculitis. Neutrophils frequently predominate in early lesions, and increased circulating neutrophils in the peripheral blood may promote production of reactive oxygen intermediates and resulting tissue damage (15,16). Indeed, many of the therapeutic options discussed below may be effective through their actions on neutrophils.…”

“…Indeed, many of the therapeutic options discussed below may be effective through their actions on neutrophils. There is also growing evidence for the role of other inflammatory cells and biochemical mediators (15–17).…”

“…Colchicine. Colchicine has proved to be useful in the treatment of EN, particularly for lesions that occur in the setting of Behçet's disease (15). Reported successful doses are between 1 and 2 mg per day, divided into twice daily dosing.…”

Behçet’s Disease as a Model of Venous Thrombosis

“…An enhanced expression of E-selectin, adhesion molecule produced by endotheliocytes, was found in patients with BD with endothelial alterations at different sites (e.g. inflamed conjunctiva, erythema nodosum), and was associated with disease activity [32][33][34][35][36][37]. Immunosuppressive therapy was shown to reduce E-selectin levels in BD [37,38].…”