Post-transplant increase in soluble human leukocyte antigen-G associated with non-severe cardiac allograft vasculopathy

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• 作者：R.M. Blanco-Garc&#237 ; a^a ; M.R. Ló ; pez-Á ; lvarez^a ; ^c ; I.P. Garrido^b ; G. Salgado-Cecilia^a ; J.A. Campillo^a ; ^c ; J.M. Bolar&#237 ; n^a ; L. Gimeno^a ; M. Muro^a ; ^c ; A.M. Garc&#237 ; a-Alonso^a ; ^c ; M.V. Mart&#237 ; nez-Sá ; nchez^a ; M.V. Bernardo Pisa^a ; S. Soriano-D&#237 ; az^a ; ^c ; D.A. Pascual-Figal^b ; M.R. Á ; lvarez-Ló ; pez^a ; ^c ; A. Minguela^a ; ^c ; ^{alfredo.minguela@carm.es}
• 关键词：CAV ; cardiac allograft vasculopathy ; HLA-G ; human leukocyte antigen-G ; HCMV ; human cytomegalovirus ; IVUS ; intravascular ultrasound ; MFI ; mean fluorescence intensity
• 刊名：Human Immunology
• 出版年：2013
• 出版时间：March, 2013
• 年：2013
• 卷：74
• 期：3
• 页码：318-324
• 全文大小：489 K

文摘

Cardiac allograft vasculopathy (CAV) is the single most important long-term limitation to heart transplantation. This study aimed to assess the value of monitoring soluble human leukocyte antigen-G (sHLA-G) during the first year post-transplantation to predict the severity of CAV, in 21 out of 77 heart recipients assessed by intravascular ultrasound (IVUS). Serum sHLA-G concentration increased after transplant in recipients free of severe CAV, but decreased in recipients suffering from severe CAV, significant differences between these two groups were found 6 to 12 months post-transplantation. The optimal value of the change in post-transplant sHLA-G for identifying severe CAV was ?0.062 % , which maximized sensitivity (80 % ) and specificity (100 % ). Importantly, increases in post-transplant sHLA-G were inversely associated with severe CAV, but directly associated with human cytomegalovirus reactivation. In addition, recipients presenting non-severe CAV or an increased sHLA-G post-transplantation, showed higher numbers of CD8⁺CD28^? T cells and a down-modulation of CD28 on CD4⁺ lymphocytes, which typically identifies CD8⁺ regulatory T cells and anergic/tolerogenic T helper cells, respectively. In conclusion, quantification of sHLA-G might offer a complementary non-invasive method for identifying recipients at risk of more severe CAV and who might benefit from earlier preventive therapies, although these results need to be confirmed in larger series.