The interaction between blood leucocytes and the vascular endothelium is essential to ensure an intact innate and adaptive immune system and maintenance of a haematopoietic homeostasis. Its failure can result in severe immunodeficiency, as impressively displayed in patients with LAD. On the other hand, uncontrolled or dysregulated leucocyte adhesion and migration can cause numerous disorders in any organ system, with enormous consequences for the integrity of crucial body functions. The latter set of inflammatory disorders is much more relevant for medical practice and public health. Modulating leucocyte adhesion seems to be an attractive approach to combat a variety of diseases. However, specificity is a major concern when interfering with a system involved in countless regulatory mechanisms and pathways. The first drugs targeting the leucocyte-endothelial interaction have recently been approved. New compounds will be developed as our understanding of the underlying molecular mechanisms continues to grow.
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