Graft-infiltrating Dendritic Cells and Coronary Endothelial Dysfunction After Human Heart Transplantation

• Published in: The Journal of heart and lung transplantation Vol. 27; no. 4; pp. 387 - 393
• Main Authors: Kofler, Sieglinde, MD, Petrakopoulou, Paraskevi, MD, Grimm, Cornelia, Kaczmarek, Ingo, MD, Meiser, Bruno M., MD, Weis, Michael, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-04-2008; Elsevier Science
• Subjects: Adult; Aged; Biological and medical sciences; Biomarkers - metabolism; Cardiology. Vascular system; Cell Adhesion Molecules - metabolism; Coronary Angiography; Coronary heart disease; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Dendritic Cells - metabolism; Dendritic Cells - pathology; Endothelium, Vascular - physiopathology; Follow-Up Studies; Heart; Heart Diseases - diagnostic imaging; Heart Diseases - pathology; Heart Transplantation; Humans; Hyperplasia; Immunohistochemistry; Lectins, C-Type - metabolism; Medical sciences; Microcirculation; Middle Aged; Myocardium - pathology; Pericardium - physiopathology; Postoperative Period; Prospective Studies; Receptors, Cell Surface - metabolism; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; T-Lymphocytes - pathology; Time Factors; Transplantation, Homologous; Tunica Intima - diagnostic imaging; Ultrasonography, Interventional; Heart; Human; Dendritic cell; Coronary artery; Cardiovascular disease; Accessory cell; Transplantation; Homotransplantation; Coronary heart disease; Phlebology; Endothelium; Treatment; Dysfunction; Surgery; Endothelial dysfunction; Graft; Circulatory system; Cardiology
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2008.01.001

Background Indirect allorecognition is involved in chronic transplant rejection. We prospectively characterized graft-infiltrating dendritic cells (DCs) in sequential myocardial biopsies ( n = 64; 1 to 24 months after transplantation) from 16 patients after heart transplantation (HTx) and analyzed the relation between graft immune activation and structural and functional coronary changes during follow-up. Methods DC invasion (immunostaining) in the human myocardium was detectable early after HTx, increased further during the first year, and decreased constantly thereafter. Also, graft-infiltrating DCs expressed markers of immaturity and maturity and were time-dependently clustered with CD3-positive T cells. Results Both epicardial and microvascular endothelial dysfunction were associated with elevated CD209-positive DCs at 12 months. CD209 positivity early after HTx was an independent marker for coronary endothelial dysfunction during follow-up. Intimal hyperplasia or angiographic disease during follow-up was not associated with myocardial DC infiltration. Conclusions DCs frequently infiltrate the cardiac allograft with a peak during the first post-operative year and time-dependently cluster with T cells. Migratory active graft-infiltrating DCs may serve as a predictor for allograft coronary endothelial dysfunction.