Monoclonal antibodies against eosinophils in liver allograft rejection.
There has been recent interest in eosinophils as a histological diagnostic marker of liver allograft rejection. However, the reliability of counting eosinophils in sections stained with hematoxylin and eosin (H&E) has not been evaluated previously. We quantified eosinophils in 10 day-5 protocol liver biopsy specimens in 10 patients. The control groups were 5 patients with cytomegalovirus infection, 5 patients with obscure liver dysfunction, and 6 patients with HCV infection. Eosinophil count was assessed using H&E and by specific monoclonal antibody staining using (1) an anti-ECP antibody (EG2) and (2) a monoclonal antibody against human eosinophil major basic protein (MBP) (BMK-13). The average percentage of the total inflammatory infiltrate of eosinophils in portal tracts was 9% in the moderate to severe rejection group as compared with 0.25% in the mild rejection group (P < .001) and 0% in the control group (P < .001). The eosinophil count decreased markedly after successful treatment of rejection. The H&E staining correlated with MBP+ the (BMK-13 immunoreactive) cells but were more numerous with BMK-13. BMK-13 also stained significantly more cells when compared with EG2 (P < .01). This difference may be because EG2 staining only activated eosinophils, whereas BMK-13 is a pan-eosinophilic maker, regardless of activation. This study confirms that eosinophils are a specific feature of acute cellular rejection and are an aid to its diagnosis. BMK-13 is a useful pan-eosinophilic marker that is more efficient in obtaining eosinophil count when compared with H&E.
Ben-Ari
Z
Z
Hepato-biliary and Liver Transplantation Unit, Royal Free Hospital and School of Medicine, Hampstead, London, United Kingdom.
Dhillon
A P
AP
Moqbel
R
R
Garwood
L
L
Booth
D
D
Rolles
K
K
Davidson
B
B
Burroughs
A K
AK
D000911:Antibodies, Monoclonal / Q000276:immunology*; D001798:Blood Proteins / Q000032:analysis* / Q000276:immunology; D047091:Eosinophil Granule Proteins; D004804:Eosinophils / Q000502:physiology*; D006084:Graft Rejection / Q000175:diagnosis*; D006801:Humans; D016031:Liver Transplantation / Q000276:immunology*; D012189:Retrospective Studies; D012260:Ribonucleases; D014184:Transplantation, Homologous
D000911:Antibodies, Monoclonal; D001798:Blood Proteins; D047091:Eosinophil Granule Proteins; D012260:Ribonucleases