MAdCAM-1

MAdCAM-1 (mucosal addressin cell adhesion molecule 1) is an endothelial addressin expressed selectively on high endothelial venules of gut-associated lymphoid tissue and on intestinal postcapillary venules. Its structure combines Ig-like domains with an extended mucin-like region carrying O-glycans. MAdCAM-1 is the dedicated ligand of the gut-homing integrin alpha 4 beta 7 and also binds L-selectin, thereby routing lymphocytes specifically to intestinal mucosa, Peyer patches and mesenteric lymph nodes. Because this pathway concentrates immune cells in the gut, MAdCAM-1 and alpha 4 beta 7 are central to inflammatory bowel disease pathogenesis and to the mechanism of vedolizumab, and anti-MAdCAM-1 antibodies are under evaluation as an alternative strategy.