Background & aims: Transmural perivascular mononuclear cell infiltrates are a feature of Crohn's disease. The aim of this study was a molecular characterization of the mechanisms leading to the formation of these infiltrates.
Methods: Endothelial cell and leukocyte expression of the adhesion molecules directing leukocyte transendothelial migration were studied in situ by immunohistochemical analysis of 10 samples from patients with Crohn's disease and 10 samples from normal controls. Double-staining methods were used to characterize the cells forming the infiltrates.
Results: CD11a+ and L-selectin-positive mononuclear cells seemed to be the major component of perivascular infiltrates. The vast majority of these cells were CD68+, CD31+ monocytes/macrophages surrounded by CD3+, L-selectin-positive, CD31+, CD45RA+, and/or CD45RO+ T lymphocytes. T lymphocytes within the vessels expressed both CD45RA and CD45RO markers. Endothelial cells were intercellular adhesion molecule 1 positive and mostly CD34+. Strong adhesion between L-selectin-positive and CD11a+ intravascular mononuclear cells and CD34+ and intercellular adhesion molecule 1-positive endothelial cells were observed.
Conclusions: Data indicate that peripheral mononuclear cells are actively recruited in the submucosa of Crohn's disease tissue; endothelial cells express adhesion molecules highly permissive for transendothelial migration of monocytes and both naive and memory T cells contributing to infiltrates generation; and close membrane contact between migrated macrophages and naive T cells leads to the T-cell transition from naive to memory phenotype within Crohn's disease.