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Updated: Jan 28 2018

Leukocyte Extravasation

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https://upload.medbullets.com/topic/106005/images/032917mdstep1pathologyleukocyteextravasation.jpg
  • Overview
  • Introduction
    • Leukocytes play an important role in eliminating offending agents
      • neutrophils and macrophages are capable of destroying microbes, necrotic tissue, and foreign substances
    • The process of leukocytes migrating from the blood vessel to tissue involves multiple steps and are mediated by adhesion molecules and chemokines
      • margination
        • leukocytes become redistributed closer to the vessel wall
      • rolling
        • leukocytes transiently attach to endothelium and then detach
          • these cells therefore "roll" on the vessel wall
        • the endothelium possesses E-selectin and P-selectin
          • cytokines from the inflamed tissue regulate selectin expression
          • Sialyl-Lewis X protein binds to E-selectin and P-selectin
            • found on leukocytes
      • firm endothelial adhesion
        • mediated by integrin proteins
          • vascular cell adhesion molecule 1 (VCAM1) and intercellular adhesion molecule-1 (ICAM-1) are found on the endothelium
          • low affinity integrin are found on leukocytes
      • migration through the vessel wall
      • migration to tissue
    • StepMolecule on Vasculature/StromaMolecule on Leukocyte
      1. Loose adhesion, rolling
      E-selection, P-selectin
      Sialyl Lewis
      2. Tight adhesion ICAM-1
      LFA-1 (integrin)
      3. Diapedesis PECAM-1PECAM-1
      4. Migration through ECMBacterial products, C5a, IL-8, LTB4, KallikreinVarious
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