#14-OR
HYPERSENSITIVITY TO SELF PROTEINS MIGHT BE A PATHOIMMUNOLOGICAL DERANGEMENT LEADING TO CHRONIC REJECTION AFTER LUNG TRANSPLANTATION.
A. Bharat, MBBS, E. Trulock, MD, G.A. Patterson, MD and T. Mohanakumar, PhD. Washington U Surg; Pulm/Int Med; Cardiothoracic and St. Louis MO, USA, Washington U, Path.
Introduction : The goal of this study was to test if hypersensitivity to collagen, present in normal and fibrosing extracellular matrix, could contribute to chronic rejection (BOS) after lung transplant.
Methodology : Peripheral blood leukocytes (PBL) from lung transplant recipients who never developed BOS or those with active rejection were stimulated twice every 8 days using collagen V in hyclone with IL-2 and T-stim. IFN-γ and IL-10 ELISPOTs were done with collagen V, using irradiated autologous PBL as antigen presenting cells. PBL from early post-transplant sample of one of the BOS+ve patients and 3 normal were used as control. Development of anti-collagen antibodies was also tested.
Results: There was no significant difference in the primary pathology and immunosuppression between groups. BOS+ve patients showed IFN- γ secretion with no IL-10 while BOS-ve recipients revealed a predominant IL-10 production. No response was detected in the early post-transplant sample of the BOS+ve patient and normal individuals. A 1:100 titre of anti-collagen I,III,IV,V antibodies was found in 3 of 4 subjects in each group but not in the normal.
Conclusions : These results demonstrate that hypersensitivity to self proteins such as collagen may contribute to BOS. The predominant Th2 (IL-10) response might contribute to the persisting graft survival in BOS-ve recipients.