ARTHRITIS & RHEUMATISM Vol. 43, No. 1, January 2000, pp 184–194 © 2000, American College of Rheumatology CELL ADHESION MOLECULES IN THE DEVELOPMENT OF INFLAMMATORY INFILTRATES IN GIANT CELL ARTERITIS Inflammation-Induced Angiogenesis as the Preferential Site of Leukocyte–Endothelial Cell Interactions MARIA C. CID, MIREIA CEBRIA ´ N, CARME FONT, BLANCA COLL-VINENT, JOSE ´ HERNA ´ NDEZ-RODRI ´ GUEZ, JORDI ESPARZA, ALVARO URBANO-MA ´ RQUEZ, and JOSEP M. GRAU Objective. To investigate the expression pattern of adhesion molecules involved in leukocyte–endothelial cell interactions in giant cell arteritis (GCA). Methods. Immunohistochemical analysis was per- formed on frozen temporal artery sections from 32 patients with biopsy-proven GCA and from 12 control patients with other diseases. Adhesion molecules iden- tified were intercellular adhesion molecule 1 (ICAM-1), ICAM-2, ICAM-3, vascular cell adhesion molecule 1 (VCAM-1), platelet endothelial cell adhesion molecule 1 (PECAM-1), E-selectin, P-selectin, L-selectin, lympho- cyte function–associated antigen 1 (LFA-1), very late activation antigen 4 (VLA-4), Mac-1 (CD18/CD11b), and gp 150,95 (CD18/CD11c). Clinical and biochemical parameters of inflammation in the patients, as well as the duration of previous corticosteroid treatment, were prospectively recorded. Results. Constitutive (PECAM-1, ICAM-1, ICAM-2, and P-selectin) and inducible (E-selectin and VCAM-1) endothelial adhesion molecules for leukocytes were mainly expressed by adventitial microvessels and neovessels within inflammatory infiltrates. Concurrent analysis of leukocyte receptors indicated a preferential use of VLA-4/VCAM-1 and LFA-1/ICAM-1 at the adven- titia and Mac-1/ICAM-1 at the intima–media junction. The intensity of inducible endothelial adhesion mole- cule expression (E-selectin and VCAM-1) correlated with the intensity of the systemic inflammatory re- sponse. Previous corticosteroid treatment reduced, but did not completely abrogate, the expression of the inducible endothelial adhesion molecules E-selectin and VCAM-1. Conclusion. Inflammation-induced angiogenesis is the main site of leukocyte–endothelial cell interac- tions leading to the development of inflammatory infil- trates in GCA. The distribution of leukocyte–endothelial cell ligand pairs suggests a heterogeneity in leukocyte– endothelial cell interactions used by different functional cell subsets at distinct areas of the temporal artery. Giant cell arteritis (GCA) is a chronic granulo- matous vasculitis involving large and medium-sized ar- teries. About 15% of individuals suffer permanent cra- nial ischemic complications, mostly visual loss, resulting from inflammation-related vessel occlusion. Patients with GCA usually experience a dramatic symptomatic relief with corticosteroid treatment, although it has not been demonstrated that corticosteroid treatment actu- ally influences the natural course of the disease (1,2). Both immune and genetic mechanisms seem to participate in the pathogenesis of GCA (2,3). Besides the histologic pattern showing granulomatous organiza- Presented in part at the 61st Annual Scientific Meeting of the American College of Rheumatology, Washington, DC, November 1997, and at the British Society of Rheumatology Meeting, Brighton, UK, April 1998. Supported by grants from Fondo de Investigacio ´n Sanitaria (FIS 95/0860 and FIS 98/0443). Ms Cebria ´n’s work was supported by a grant from the Ministerio de Educacio ´n y Ciencia. Drs. Font and Herna ´ndez-Rodrı ´guez’s work was supported by a research award from the Hospital Clı ´nic. Maria C. Cid, MD, Mireia Cebria ´n, Graduate Student, Carme Font, MD, Blanca Coll-Vinent, MD, Jose ´ Herna ´ndez-Rodrı ´guez, MD, Jordi Esparza, Graduate Student, Alvaro Urbano-Ma ´rquez, MD, Josep M. Grau, MD: University of Barcelona, Barcelona, Spain. Address reprint requests to Maria C. Cid, MD, Department of Internal Medicine, Hospital Clı ´nic, Villarroel 170, 08036-Barcelona, Spain. Submitted for publication March 11, 1999; accepted in revised form September 3, 1999. 184