Expression of ICAM-1 in Chronic Venous Leg Ulcers
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Thirty patients were chosen, in an attempt to study the expression of the intercellular adhesion molecule-1 (ICAM-1) in patients with chronic venous insufficiency of the lower limbs. Punch biopsy specimens were obtained and studied on immunohistochemical basis. This was done using monoclonal antibody detection to determine the sites and degree of ICAM-1 expression. The patients were first diagnosed on clinical basis and confirmed by Doppler sonography and phlebography. The biopsy specimens were obtained from the dermatoliposclerotic skin of the lower limb. Five control biopsy specimens were also taken from normal skin in equivalent areas from age and sex matched healthy adults. ICAM-1 expression was detected in 17 cases (56.7%). This expression was mainly on the endothelial cells. However the degree of expression varied in different sites. It was highest on the capillaries at the ulcer sites. This increased expression of the ICAM-I on the endothelial cells strongly supported a pathogenic mechanism in the development of chronic venous insufficiency and ulcer formation, that is; increased leucocyte adhesion to the endothelial cells mediated by these molecules.