Intragraft interleukin 2 mRNA expression during acute cellular rejection and left ventricular total wall thickness after heart transplantation
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.
|Keywords||Acute Disease, Adolescent, Adult, Biopsy/methods, Echocardiography, Doppler, Female, Graft Rejection/*etiology/metabolism/pathology, Heart Transplantation/*immunology/pathology, Heart Ventricles/pathology, Humans, Interleukin-2/*metabolism, Male, Middle Aged, Postoperative Complications/*immunology/metabolism/pathology, RNA, Messenger/metabolism, Transplantation, Homologous, Ventricular Dysfunction, Left/etiology/pathology|
de Groot-Kruseman, H.A., Baan, C.C., Hagman, E.M., Mol, W.M., Niesters, H.G.M., Zondervan, P.E., … Maat, A.W.P.M.. (2002). Intragraft interleukin 2 mRNA expression during acute cellular rejection and left ventricular total wall thickness after heart transplantation. Heart, 87(4), 363–367. Retrieved from http://hdl.handle.net/1765/8338