Epidermal Keratinocytes of Bullous Pemphigoid Express Intercellular Adhesion Molecule‐1 (ICAM‐1)

Intercellular adhesion molecule-1 (ICAM-1) is the ligand for lymphocyte function associated antigen-1 (LFA-1), mediating the adhesion of lymphocytes to vascular endothelium. Keratinocytes are known to express ICAM-1 in some inflammatory dermatoses. Using an indirect immunofluorescence method, we examined the patterns of ICAM-1 and LFA-1 staining in bullous pemphigoid (BP) lesions and compared them to pemphigus vulgaris (PV) cases. ICAM-1 was expressed on the cell surface and in the cytoplasm of epidermal keratinocytes at the sites of erythematous and bullous lesions of BP. LFA-1 molecules were expressed on T cells at the basement membrane zone. In addition, HLA-DR-positive keratinocytes were observed in the basal layer. ICAM-1 was not, however, expressed on epidermal keratinocytes in uninvolved skin from BP patients, PV or normal control skin. It is known that ICAM-1 is expressed on keratinocytes at the site of lymphoid infiltration in cutaneous dermatoses and that LFA-1-positive T cells can bind to interferon gamma-induced ICAM-1-positive keratinocytes. Our results suggest that cellular immunity involving ICAM-1 and LFA-1 may play a part in the pathogenesis of bullous pemphigoid.