Relative upregulation of ICAM-1 gene expression on retinal microvascular endothelium, which overall was approximately 11-fold more highly expressed on retinal versus choroidal endothelium, according to our microarray data, is of particular interest because studies in EAU have implicated this cell adhesion molecule in T-cell migration into the eye during posterior uveitis. Treatment with a blocking antibody directed against ICAM-1, or its ligand, lymphocyte function-associated antigen (LFA)-1, are reported to suppress inflammation in this model,
42 43 and upregulation of ICAM-1 is noted during EAU.
8 We observed 2.4- and 4.2-fold upregulation of ICAM-1 gene expression by retinal endothelial cells after exposure to
T. gondii tachyzoites and LPS, respectively. Although immune-mediated uveitis is in general CD4-positive T-cell mediated, one rare cause of posterior uveitis which often coexists with intracranial pathology is primary central nervous system (CNS) lymphoma,
44 a diffuse non-Hodgkin B cell lymphoma. The source of the B cells that cause this tumor remains unknown, as there are no lymphoid collections within the CNS. A common theory is that malignant B cells home to this location.
45 Significantly, ICAM-1 has been shown to be an important mediator of B-cell migration into the brain; B cells migrate more efficiently across unstimulated cultured human brain endothelial cells than T cells, and this movement is significantly reduced by blocking ICAM-1.
46 Also defying explanation is why infections with
T. gondii parasites preferentially evolve within the retina and brain in humans. ICAM-1 may be a receptor for
T. gondii tachyzoites or leukocytes infected with the parasite. Recent studies have implicated ICAM-1 in the passage of tachyzoites across the gut epithelium
47 and in the binding of infected monocytes to placental trophoblast cells.
48 Conceivably, the relatively high expression of ICAM-1 on retinal endothelium might provide receptors for the parasite and/or inflammatory cells that concurrently enter the eye. ICAM-1 has also been implicated in diabetic retinopathy,
49 50 another disease that selectively involves retinal vasculature. Results of other studies suggest that ICAM-1 is expressed at dissimilar levels on different extraocular human endothelial cells: for example, Kanda et al.
41 reported that ICAM-1 was expressed at a relatively higher level on cultured human aortic endothelium in comparison to vena caval and dermal microvascular endothelia. Differences in methodology prevent us from drawing conclusions about ocular versus extraocular endothelial expression of ICAM-1.