Published online before print April 15, 2002, doi: 10.1161/01.CIR.0000015075.89984.46
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(Circulation. 2002;105:1949.)
© 2002 American Heart Association, Inc.
Clinical Investigation and Reports |
Human Leukocyte Antigen-G Expression After Heart Transplantation Is Associated With a Reduced Incidence of Rejection
From the Laboratory for the Study of Cardiac Grafts and Prostheses, University of Pierre et Marie Curie, Broussais Hospital (N.L., A.C.); the Department of Cardiovascular Surgery and Organ Transplantation, Georges Pompidou Hospital (C.A., R.G., P.C., C.L., J.-N.F., A.C.); and Research Institute for Hemato-Immunology, CEA Laboratory, Saint-Louis Hospital (J.D., E.D.C.), Paris, France.
Correspondence to Nermine Lila, DVM, Laboratory for the Study of Cardiac Grafts and Prostheses, University of Pierre et Marie Curie, Broussais Hospital, 96 rue Didot 75014 Paris, France. E-mail nerminelila{at}yahoo.fr
Background— Human leukocyte antigen (HLA)-G, a nonclassic major histocompatibility complex class I molecule expressed in the extravillous cytotrophoblast at the feto-maternal interface, is known to protect the fetus from maternal cellular immunity. In a preliminary study, we showed that HLA-G is expressed in the hearts of some patients after heart transplantation.
Methods and Results— In the present study, a larger number of patients was investigated to confirm this finding and to look for possible correlations between HLA-G expression and the number and types of rejection. Expression of HLA-G in endomyocardial biopsy specimens was investigated by immunohistochemical analysis, and detection of the soluble HLA-G in the serum was performed by immunoprecipitation followed by Western blot analysis. HLA-G was detected in the biopsy specimens and serum of 9 of 51 patients (18%). The number of episodes of acute rejection was significantly lower in HLA-G-positive patients (1.2±1.1) as compared with HLA-G-negative patients (4.5±2.8) (P<0.001). No chronic rejection was observed in HLA-G-positive patients, whereas 15 HLA-G-negative patients had chronic rejection (P<0.032). A longitudinal study of these patients reveals that the status of HLA-G expression was maintained after 6 months both in serum and in biopsy specimens. During this period, HLA-G-positive patients did not have chronic rejection.
Conclusions— There is a significant correlation between rejection and HLA-G expression in the heart after transplantation. HLA-G expression and its effect in reducing the incidence and severity of rejection seem to be stable throughout the evolution.
Key Words: transplantation • genes • rejection • grafting
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