Granulocyte Adhesion and Diapedesis

Granulocyte adhesion and diapedesis is a crucial part of the immune defense, in which white blood cells, specifically neutrophils, eosinophils and basophils, adhere to blood vessel walls and migrate into tissues. The targeted delivery of these immune cells to affected areas is pivotal in combating infections and inflammation.

Granulocyte Adhesion and Diapedesis

Pathway Summary

The inflammatory reaction enables an organism to defend itself against infectious microbes. The migration of leukocytes or WBCs from the vascular system to sites of pathogenic exposure is a key event in the process of inflammation. Migration of leukocytes is initiated by the process of cell adhesion, followed by transmigration. These processes vary according to the nature of the blood vessels and type of leukocytes (granulocyte or agranulocyte) that are involved. Adhesion and diapedesis of granulocytes (neutrophils, basophils and eosinophils) have mostly been analyzed in the context of non-lymphoid endothelium. The polymorphonuclear neutrophils (PMNs) are the first line of host defense against infection by bacterial pathogens and are rapidly recruited to sites of bacterial invasion. Although eosinophils and basophils are the least abundant circulating leukocytes, an increasing body of evidence suggests that the latter play an active pathogenic role in allergic inflammation by releasing diverse pro-inflammatory mediators, including vasoactive amines, cysteinyl leukotrienes and cytokines.An inflammatory response induced by infection, injury or an allergen, triggers granulocytes to move into tissues towards the foreign invader, in a process called extravasation. In general, extravasation of leukocytes is a multi-step process that involves 1) tethering 2) rolling and activation 3) firm adhesion to the endothelium 4) diapedesis and finally 5) transendothelial migration. In response to inflammation, endothelial cells exocytose P-selectin and E-selectin and enhance release of chemokines through transcytosis. P-selectin and E-selectin bind to their respective ligands PSGL1 and ESL1, on granulocytes and mediate the initiation of cell contact between granulocytes and endothelial cells. In contrast to the rapidly flowing cells in the blood stream, rolling cells are able to sense signals from the endothelium which stimulates them to adhere more firmly to the endothelial cell surface. Such signaling molecules include chemokines which act through CXCRs /CCRs and G-protein. Often chemokines like SDF1 are presented and immobilized by Sdcs, cell surface proteoglycans, on the endothelium. These stimulatory effects cause activation of integrins, which in turn bind to members of the immunoglobulin superfamily on the endothelial cell surface. The major integrins involved in this process are LFA1 (a complex of Itg-αL and Itg-β2) and Mac1 (a complex of Itg-αM and Itg-β2) which bind to members of the immunoglobulin superfamily such as ICAM1, ICAM2 and VCAM1 on the non-lymphoid endothelial cell surfaces. This causes tight adherence of granulocytes to the endothelium.Cross-linking of integrins with ICAMs and VCAM1 activates the ERM (ezrin, radixin, moesin) proteins and recruits Thy1 to the cell surface. This interaction enables binding of PECAM1 and also facilitates attachment of junctional adhesion proteins like JAM2 and JAM3 with the granulocyte integrins. This cross-linking results in the docking of granulocytes to the apical surface of endothelial cell and triggers signals through generation of ROS and formation of stress fibers that further results in the activation of MMPs. Activated MMPs and ROS degrade the assembly of junctional proteins like VEC and other CAMs, leading to the opening of inter-endothelial cell contacts, allowing granulocytes to transmigrate and reach the underlying tissue.

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Frequently Asked Questions

What is the granulocyte adhesion and diapedesis pathway?

The granulocyte adhesion and diapedesis pathway is a complex immunological process that allows white blood cells, specifically granulocytes like neutrophils, eosinophils, and basophils, to adhere to the endothelial cells lining blood vessels and then migrate through the vessel walls into surrounding tissues. This mechanism is a fundamental component of the immune response.

What are granulocytes, and how do they recognize sites of infection or inflammation?

Granulocytes are a type of white blood cell that play a key role in the immune system's response to infections and inflammation. When infection or inflammation occurs, cells at the site release chemical signals called chemokines. The granulocytes have specific receptors on their surfaces that detect and bind to these chemokines. This binding triggers a series of events that guide the granulocytes to migrate towards the precise location where they are needed to combat pathogens or address tissue damage. 

What are the key adhesion molecules involved in granulocyte adhesion and diapedesis?

Adhesion molecules are proteins that facilitate cell-to-cell or cell-to-matrix interactions. Several key adhesion molecules play crucial roles in the granulocyte adhesion and diapedesis pathway and ensure that granulocytes can effectively adhere to and migrate through the endothelium, so they can reach the infection or inflammation sites.

  • Selectins: Selectins are adhesion molecules that initiate rolling interactions between granulocytes and the endothelial cells lining blood vessels. They help slow down granulocytes, making it easier for them to adhere.
  • Integrins: Integrins are vital for mediating firm adhesion. They enable granulocytes to firmly attach to the endothelial cells, preventing them from being swept away by the bloodstream.
  • Intercellular Adhesion Molecules (ICAMs): ICAMs strengthen the attachment between granulocytes and endothelial cells, further promoting adhesion. They are essential for the stable binding of granulocytes to the vessel wall.
Why is granulocyte adhesion essential for the immune response?

Granulocyte adhesion is a fundamental step in the immune response because it allows immune cells to precisely target specific sites of infection or tissue injury. This targeted recruitment ensures that immune cells, particularly granulocytes, can concentrate their efforts at the exact location where pathogens are present or tissue damage has occurred, thereby enhancing the overall effectiveness of the immune response. Without efficient adhesion, immune cells might be dispersed throughout the bloodstream, reducing their ability to rapidly and effectively address the threat.

What is diapedesis, and why is it important?

Diapedesis, also known as transmigration, is the intricate process by which granulocytes migrate through the endothelial cell layer that lines blood vessels and subsequently enter the surrounding tissue. This process involves a series of precisely orchestrated steps, including the initial tethering and rolling of granulocytes along the endothelium, their firm adhesion to the endothelial cells, and their eventual passage through the endothelial barrier. Diapedesis is highly important in the immune response because it allows immune cells to reach the precise site of infection or inflammation, where they can effectively combat pathogens, release antimicrobial substances, and contribute to tissue repair. This ensures that the immune system is optimally positioned to protect the body against threats.

How is granulocyte adhesion and diapedesis regulated?

Intricate regulatory mechanisms control the intensity and duration of granulocyte adhesion and diapedesis, to maintain immune homeostasis and prevent immunopathological conditions. One such mechanism is the use of negative feedback loops. When immune cells detect that they have reached the site of infection or inflammation, various signaling pathways are activated to halt further adhesion and migration. This prevents excessive immune cell accumulation and reduces the risk of tissue damage and chronic inflammation. In addition, regulatory molecules, such as anti-inflammatory cytokines, help fine-tune these processes to ensure a balanced immune response. 

What are the health effects of dysregulated adhesion and diapedesis?

Dysregulation of the adhesion and diapedesis processes can result in a variety of health issues, including chronic inflammation, autoimmune diseases, or impaired immune responses. Excessive adhesion can lead to chronic inflammation and tissue damage. When granulocytes adhere excessively to blood vessel walls, they can release inflammatory molecules, causing prolonged inflammation that is associated with conditions such as atherosclerosis and inflammatory bowel diseases.

Conversely, insufficient adhesion can result in compromised immune responses. If granulocytes fail to adhere efficiently and migrate to sites of infection or injury, the body's ability to combat pathogens becomes compromised. This can lead to an increased susceptibility to infections and slower wound healing.

Dysregulated adhesion and diapedesis can also exacerbate autoimmune diseases by contributing to tissue damage and the immune system's misdirected attacks on the body's own tissues.

Crossing Vascular Barriers: Insights into Granulocyte Adhesion and Diapedesis

Granulocyte adhesion and diapedesis – also referred to as granulocyte extravasation, granulocyte migration, leukocyte adhesion and transmigration, neutrophil recruitment, leukocyte trafficking, and leukocyte infiltration – represents a crucial process in the immune response. These various terms are often used interchangeably to describe the same fundamental mechanism in which a particular subset of white blood cells adhere to blood vessel walls and then migrate through the vessel walls into surrounding tissues to combat infections, assist in wound healing, or regulate immune reactions.

The Importance of Granulocyte Migration

White blood cells (also known as leukocytes) are an important part of the immune system, as they are responsible for detecting, attacking and removing pathogens from the body. There are two broad categories of white blood cells: granulocytes and agranulocytes, named according to the presence or absence of distinctive granules in their cytoplasm.

There are three types of granulocytes typically found circulating in the bloodstream: neutrophils, eosinophils, and basophils. Neutrophils are the most abundant type of white blood cell and are often the first responders to bacterial infections. They are highly effective at phagocytosis, which is the process of engulfing and digesting invading pathogens. Eosinophils are primarily involved in combating parasitic infections and regulating allergic responses, while basophils play a role in allergic reactions and immune responses to parasites.

Granulocytes are essential to the immune system because they are part of the body's first line of defense against invading pathogens. The ability of neutrophils, eosinophils, and basophils to migrate from the bloodstream to the site of infection or inflammation is crucial for a rapid and effective immune response. The granulocyte adhesion and diapedesis signaling pathway is the process through which these cells adhere to blood vessel walls and then migrate through the vessel walls into surrounding tissues. This pathway allows a precisely targeted response and the delivery of immune cells to the locations where they can combat infections, assist in wound healing, or regulate immune reactions.

Wound Healing

Neutrophils are vital for wound healing. When tissue is injured, neutrophils are among the first responders to migrate to the site of the wound. They help clear away debris and potential pathogens, facilitating the initial stages of tissue repair.

Bacterial Infections

Neutrophils are also highly effective against bacterial infections. When the body detects the presence of bacteria, neutrophils are recruited to the infected area. They can engulf and destroy bacteria through a process called phagocytosis, helping to eliminate the infection.

Parasitic Infections

Eosinophils are specialized in combating parasitic infections. When the body encounters parasitic invaders, eosinophils are mobilized to the site of infection. They release toxic substances that are effective against parasites, helping to limit their spread.

Allergic Responses

Basophils and eosinophils are involved in allergic reactions. When allergens enter the body, basophils release histamines and other inflammatory substances that contribute to allergy symptoms. Eosinophils, on the other hand, help regulate and control allergic responses, preventing them from becoming excessive.

The Granulocyte Adhesion and Diapedesis Process

Granulocyte adhesion involves a multi-step sequence of tightly regulated interactions between cell adhesion molecules, chemokines, and immune cells that guide the granulocytes through the blood vessel walls to sites of infection or inflammation.

Tethering / Capture

During tethering, which is also known as capture, granulocytes that are circulating in the bloodstream approach the inner lining of the blood vessel, which is composed of endothelial cells. Weak interactions between the adhesion molecules E-selectin and P-selectin on inflamed endothelial cells and L-selectin on the leukocytes prevents the leukocytes from being swept away by the blood flow and provides an opportunity for more stable interactions to take place.

Rolling and Slow Rolling

After tethering, the granulocytes make controlled rolling movements along the endothelial surface. This rolling is facilitated by continued interactions between selectins on both cell types. The movement of the granulocytes along the vessel wall increases their likelihood of encountering inflammatory signals at a site of infection or inflammation and becoming activated.


While rolling, granulocytes are exposed to various signals from the endothelial cells and surrounding microenvironment. These signals include chemokines, interleukins, and other mediators. These exposures activate the granulocytes and lead to the upregulation of adhesion molecules on the surface of granulocytes. As a result, the rolling interactions become more robust and effective in guiding granulocytes to their intended destination within tissues.

Firm Adhesion / Arrest

Firm adhesion (or arrest) is a critical step in the granulocyte adhesion and diapedesis pathway where granulocytes firmly attach to the endothelial cells lining blood vessels. This robust adhesion is mediated by integrins and ensures that granulocytes remain in place at the site of infection or inflammation.

Adhesion Strengthening and Spreading

Following arrest, adhesion between granulocytes and endothelial cells strengthens further. Integrins play a key role in this process, forming more stable bonds. Granulocytes also undergo a shape change, flattening and spreading against the endothelial cell surface. These changes in shape and enhanced adhesion prepare granulocytes for the subsequent steps.

Intravascular Crawling

Intravascular crawling, also known as lateral migration, is a process where granulocytes move along the luminal surface of the endothelium in search of suitable sites for transmigration. This step allows granulocytes to explore the endothelial cell surface for regions where diapedesis can occur most effectively.

Paracellular and Transcellular Diapedesis / Transmigration

Granulocytes can undergo two main routes of transmigration—paracellular and transcellular. In paracellular transmigration, granulocytes squeeze between adjacent endothelial cells through small gaps known as tight junctions. In transcellular transmigration, granulocytes migrate directly through individual endothelial cells, passing through the cell body. Both routes allow granulocytes to cross the endothelial barrier and enter the surrounding tissue.

Regulation of Granulocyte Adhesion and Diapedesis

The regulation of granulocyte adhesion and diapedesis is finely orchestrated by various regulatory factors, including anti-inflammatory cytokines. These cytokines, such as interleukin-10 (IL-10) and transforming growth factor-beta (TGF-β), play a crucial role in controlling the intensity and duration of adhesion and diapedesis. They exert their effects by dampening pro-inflammatory signaling pathways and inhibiting the expression of adhesion molecules on endothelial cells. By reducing the availability of adhesion molecules like selectins and ICAMs, anti-inflammatory cytokines help prevent excessive granulocyte adhesion and migration, thereby limiting tissue damage and inflammation. This regulation ensures a balanced immune response, where granulocytes are recruited appropriately without causing collateral harm.

Negative feedback mechanisms are integral to the precise regulation of granulocyte adhesion and diapedesis. These mechanisms act as a safeguard against excessive inflammation and immune cell activation. One crucial aspect of negative feedback is the downregulation of adhesion molecules and chemokine receptors.

When immune cells detect that they have reached the site of infection or inflammation, signaling pathways are activated to halt further adhesion and migration. This includes internalization and degradation of adhesion molecules and receptors. For instance, chemokine receptor internalization can occur, reducing the responsiveness of granulocytes to chemoattractants.

In addition, anti-inflammatory cytokines can also participate in downregulating the expression of adhesion molecules and chemokine receptors. These mechanisms collectively ensure that once the immune cells have effectively reached the infection or inflammation site, they do not continue to accumulate excessively, reducing the risk of tissue damage and chronic inflammation.

Dysregulation and the Clinical Implications

Dysregulation of granulocyte adhesion and diapedesis can lead to various pathological conditions. Excessive adhesion and migration may result in chronic inflammation, contributing to autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus. In these conditions, the immune system mistakenly targets the body's own tissues due to heightened immune cell activity.

Conversely, insufficient adhesion and migration can compromise immune responses, leaving the body more susceptible to infections and impairing its ability to address tissue damage promptly, as seen in conditions like immunodeficiency disorders. Overall, balanced regulation of these processes is essential for maintaining immune homeostasis and preventing immunopathological conditions.

Therapeutic Potential

Researchers are actively exploring therapeutic strategies that target granulocyte adhesion and diapedesis for various medical conditions. In autoimmune diseases like rheumatoid arthritis or multiple sclerosis, therapies aim to inhibit specific adhesion molecules or chemokine receptors involved in immune cell infiltration into healthy tissues. This approach can help mitigate autoimmune responses and reduce tissue damage.

In the context of chronic inflammatory conditions such as atherosclerosis or inflammatory bowel diseases, there is interest in developing drugs that selectively regulate adhesion molecule expression or chemokine signaling. These medications could prevent excessive inflammation and tissue damage, thereby improving the overall management of chronic inflammatory disorders.

Additionally, in the field of cancer immunotherapy, researchers are investigating ways to enhance immune cell recruitment to tumors using granulocyte adhesion and diapedesis pathways. By improving the body's ability to deliver immune cells to cancerous tissues, these strategies aim to enhance the recognition and eradication of cancer cells, potentially boosting the effectiveness of cancer treatments.

Further Reading

Chavakis E, Choi EY, Chavakis T. Novel aspects in the regulation of the leukocyte adhesion cascade. Thromb Haemost. 2009 Aug;102(2):191-7. doi: 10.1160/TH08-12-0844.

Filippi MD. Mechanism of Diapedesis: Importance of the Transcellular Route. Adv Immunol. 2016;129:25-53. doi: 10.1016/

Filippi MD. Neutrophil transendothelial migration: updates and new perspectives. Blood. 2019 May 16;133(20):2149-2158. doi: 10.1182/blood-2018-12-844605.

Janeway CA Jr, Travers P, Walport M, et al. Immunobiology: The Immune System in Health and Disease. 5th edition. New York: Garland Science; 2001. The components of the immune system. Available from:

Ley K, Laudanna C, Cybulsky MI, Nourshargh S. Getting to the site of inflammation: the leukocyte adhesion cascade updated. Nat Rev Immunol. 2007 Sep;7(9):678-89. doi: 10.1038/nri2156.

Mitroulis I, Alexaki VI, Kourtzelis I, Ziogas A, Hajishengallis G, Chavakis T. Leukocyte integrins: role in leukocyte recruitment and as therapeutic targets in inflammatory disease. Pharmacol Ther. 2015 Mar;147:123-135. doi: 10.1016/j.pharmthera.2014.11.008.

Muller WA. Getting leukocytes to the site of inflammation. Vet Pathol. 2013 Jan;50(1):7-22. doi: 10.1177/0300985812469883.

Nourshargh S, Alon R. Leukocyte migration into inflamed tissues. Immunity. 2014 Nov 20;41(5):694-707. doi: 10.1016/j.immuni.2014.10.008.

Petri B, Bixel MG. Molecular events during leukocyte diapedesis. FEBS J. 2006 Oct;273(19):4399-407. doi: 10.1111/j.1742-4658.2006.05439.x.