MRCEM Notes

Leucocyte extravasation

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Leucocyte extravasation can be thought to occur in 4 stages:
  • 1. Chemoattraction
  • 2. Rolling
  • 3. Tight adhesion
  • 4. Transmigration

Chemoattraction and rolling

Macrophages in the affected tissue release cytokines such as IL-1, TNF-α. This both attracts circulating leucocytes and causes the endothelium to express cellular adhesion molecules such as selectins.

Tight adhesion


Leucocytes express integrins in response to the cytokines. These bind to ICAM proteins on endothelial cells.

Transmigration


PECAM proteins on both endothelial cells and leucocytes interact and facilitate the migration of the leucocytes through the endothelium.
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