Endomyocardial biopsies after heart transplantation. The presence of markers indicative of activation
Wijngaard, P.L.; Tuijnman, W.B.; Gmelig Meyling, F.H.; van der Meulen, A.; Huytink, M.; Jambroes, G.; Schuurman, H.J.
Transplantation 55(1): 103-110
1993
ISSN/ISBN: 0041-1337 PMID: 8420034 Document Number: 417484
A series of 104 endomyocardial biopsies (EMB) from patients after heart transplantation was evaluated for the presence of immunological markers on graft component and infiltrating cells. This included markers for cells expressing alpha-beta-T-cell receptors and gamma-delta-T-cell receptors, and cytotoxic T cells with granules bearing the serine esterase Granzyme B; the presence of activation markers identified by CD25 (interleukin 2 receptor), CD30, CD69 (activation inducer molecule), CDw70; macrophages using antibody CD14 (WT14), and cells with Fc-gamma-receptors type III (CD16). Almost all cells in T-cell infiltrates expressed the alpha-beta-T cell receptor. Cells bearing the gamma-delta-T cell receptor were scarcely found. The analysis with respect to the histopathologic diagnosis for rejection showed an absence of significance for T cell subsets, Granzyme B-positive cells, and activation markers except CD25. The numbers of macrophages labeled by CD14 and cells expressing Fc-gamma-RIII showed a significant relation to histopathology of rejection. Apart from leukocytes, also endothelium in EMB with rejection was labeled by the two anti-Fc-gamma-RIII antibodies used. In addition, in a small series of biopsies investigated, Fc-gamma-RI- and Fc-gamma-RIII-positive cells were increased in EMB with rejection, and endothelium was labeled by Fc-gamma-RII antibodies. A cluster analysis on the basis of scores for CD25, CD14, and anti-Fc-gamma-RIII revealed three main clusters, one cluster comprising biopsies without abnormalities, one cluster containing EMB with the histopathology of rejection and high scores in immunophenotyping of rejection and high scores in immunophenotyping for lymphocytes and macrophages, and one cluster in between. The present data emphasize the importance of macrophage assessment in evaluating pathologic processes during rejection of heart allografts and diagnosing rejection.