The importance of E-selectin as a marker for renal transplant rejection.
Vascular endothelial cells express membrane bound adhesion molecules which play a direct role in the localization and subsequent movement of leucocytes from the blood into sites of inflammation. E-Selectin is a cytokine induced adhesion molecule, known to be expressed by endothelial cells in inflammatory conditions, which binds to various leucocyte subpopulations. In a prospective study we have investigated the expression and distribution of E-selectin on renal allograft needle biopsies taken from 16 pretransplant kidneys and 119 post-transplant kidneys. Post-transplant biopsies were taken at times of graft dysfunction and at times of normal graft function. Formal histology was also performed and assessed independently. E-Selectin was found predominantly on the intertubular endothelium and on the endothelium of larger vessels. E-Selectin was present, at low intensity, in some pretransplant biopsies and also some post-transplant biopsies which were reported histologically as normal. In post-transplant biopsies taken for dysfunction E-selectin was present in the majority of cases. Expression was strong in biopsies showing acute cellular rejection and this was associated with a CD4 positive cellular infiltrate. Biopsies showing other causes of dysfunction, in particular acute tubular necrosis, also were E-selectin and CD4 positive with lower intensity than those with acute cellular rejection. These results suggest that E-selectin is a good marker for endothelial activation in renal transplant biopsies. Its presence in histologically apparently normal biopsies suggests that its in vivo kinetics may differ from previously reported in vitro kinetics. E-Selectin may be a potential target for therapeutic intervention.
Morgan
J D
JD
Department of Surgery, Leicester General Hospital, UK.
Lycett
A
A
Horsburgh
T
T
Nicholson
M L
ML
Veitch
P S
PS
Bell
P R
PR
D015415:Biomarkers; D001706:Biopsy; D015704:CD4 Antigens / Q000032:analysis; D015815:Cell Adhesion Molecules / Q000032:analysis*; D019040:E-Selectin; D006084:Graft Rejection; D006801:Humans; D007668:Kidney / Q000737:chemistry; D016030:Kidney Transplantation / Q000276:immunology*
D015415:Biomarkers; D015704:CD4 Antigens; D015815:Cell Adhesion Molecules; D019040:E-Selectin