Intragraft interleukin 2 mRNA expression during acute cellular rejection and left ventricular total wall thickness after heart transplantation

Abstract

Objective: To assess whether diastolic graft function is influenced by intragraft interleukin 2 (IL-2) messenger RNA (mRNA) expression in rejecting cardiac allografts. Design: 16 recipients of cardiac allografts were monitored during the first three months after transplantation. The presence of IL-2 mRNA in endomyocardial biopsies (n = 123) was measured by reverse transcriptase polymerase chain reaction. To determine heart function, concurrent M mode and two dimensional Doppler echocardiograms were analysed. Results: Histological signs of acute rejection (International Society for Heart and Lung Transplantation (ISHLT) rejection grade > 2) were strongly associated with IL-2 mRNA expression (IL-2 mRNA was present in 12 of 20 endomyocardial biopsies (60%) with acute rejection and in 24 of 103 endomyocardial biopsies (23%) without acute rejection, p = 0.002). No significant relation was found between either histology or IL-2 mRNA expression alone and the studied echocardiographic parameters. However, stratification of the echocardiographic data into those of patients with and those without acute rejection showed that during acute rejection IL-2 mRNA expression was significantly associated with increased left ventricular total wall thickness (mean change in total wall thickness was +0.22 cm in patients with IL-2 mRNA expression versus −0.18 cm in patients without IL-2 mRNA expression, p = 0.048). Conclusions: An increase in left ventricular total wall thickness precedes IL-2 positive acute rejection after heart transplantation. Thus, cardiac allograft rejection accompanied by intragraft IL-2 mRNA expression may be indicative of more severe rejection episodes.

Defective Inhibition of Peripheral Cd8+ T Cell Il-2 Production by Anti-Calcineurin Drugs During Acute Liver Allograft Rejection

“…The IL-2 levels in serum or plasma are not reliable for the diagnosis of rejection (19,20). IL-2 expression has been assessed in graft tissue samples to evaluate its role in acute rejection (21)(22)(23), but this is clearly not possible in routine practice. The pattern of cytokine in peripheral blood lymphocytes has been found to correlate with that of lymphocytes infiltrating the liver graft during acute rejection (21).…”

Value of FOXP3 Expression in Peripheral Blood as Rejection Marker After Miniature Swine Lung Transplantation

“…36 Recent studies, however, have shown that IL-2 is also critically required for activation and maintenance of the Tregs. 37,38 Thus, the Rotterdam group speculated that the non-Tregs and the Tregs, both of which were IL-2 dependent, were recruited within rejecting grafts simultaneously in the presence of allo-antigens, and that the upregulation of the intragraft FOXP3 mRNA level was caused by the latter.…”

An Echocardiographic Left Ventricular Wall Area Index for Functional Detection of Myocardial Injury in Hemodynamically Unloaded Hearts

“…26 This is evidenced by an increase in the myocardial wall thickness, which can be assessed by echocardiography. 27,28 Studies have also attempted to correlate endomyocardial biopsy-proven rejection with echocardiographically derived changes in LV mass. [29][30][31][32] Clinically, echocardiography has been investigated as a noninvasive method of assessing heart transplant rejection since the late 1960s.…”

“…Acute rejection of the transplanted cardiac allograft in humans is characterized by diffuse inflammation, myocyte necrosis, infiltration by the mononuclear cells, and myocardial edema 26 . This is evidenced by an increase in the myocardial wall thickness, which can be assessed by echocardiography 27,28 . Studies have also attempted to correlate endomyocardial biopsy‐proven rejection with echocardiographically derived changes in LV mass 29–32 .…”