title: CD40 and CD40 ligand (CD154) are coexpressed on microvessels in vivo in human cardiac allograft rejection.
abstract: BACKGROUND
  CD40 is expressed by a wide variety of cells in the immune system, including endothelial cells. It binds to CD40 ligand ([CD40L] CD154), which was originally reported to be restricted in its expression to early-activated T cells. We report here the expression of CD40 and CD40L in human cardiac allografts.
  
  
  METHODS
  A total of 123 consecutive biopsies from 11 human cardiac allograft recipients were analyzed by immunohistochemistry for the expression of CD40 and CD40L. The expression of CD40L was also examined in vitro in homogeneous cultures of umbilical vein endothelial cells by reverse transcriptase-polymerase chain reaction and by flow cytometry.
  
  
  RESULTS
  CD40 was expressed at low levels, and CD40L was minimal or absent in histologically normal biopsies in the absence of CD3+ T-cell infiltrates. In rejection, the expression of CD40 increased on vascular endothelial cells and on graft-infiltrating leukocytes throughout biopsy specimens. Induced expression of CD40 was strongly associated with the presence of CD3+ T-cell infiltrates, acute rejection, and ischemic injury (P<0.05). CD40L was expressed in biopsies with rejection and was prominent on a subset of infiltrating leukocytes as well as on microvascular endothelial cells. In contrast to CD40, staining of endothelial CD40L was focal in most biopsies. Overall, the expression of CD40L correlated with the presence of CD3+ T-cell infiltrates and rejection (P<0.05), but not ischemic injury (P=0.9). To confirm that the endothelium can synthesize CD40L, we also evaluated the expression of endothelial CD40L in vitro. Cultured endothelial cells were found to express little constitutive CD40L that markedly increased after 24 hr of treatment with supernatants from phytohemagglutinin-activated peripheral blood mononuclear cells or by the cytokines tumor necrosis factor-alpha, interleukin-1a, interleukin-4, or interferon-gamma.
  
  
  CONCLUSIONS
  Both CD40 and CD40L are expressed in vivo on infiltrating leukocytes and on microvascular endothelium in human cardiac allograft rejection. We suggest that endothelial cell CD40 and CD40L play a role in human cell-mediated immune responses such as cardiac allograft rejection.
authors.affiliation: Department of Cardiothoracic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02155, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Reul
authors.forename: J C
authors.initials: JC
authors.lastname: Fang
authors.forename: M D
authors.initials: MD
authors.lastname: Denton
authors.forename: C
authors.initials: C
authors.lastname: Geehan
authors.forename: C
authors.initials: C
authors.lastname: Long
authors.forename: R N
authors.initials: RN
authors.lastname: Mitchell
authors.forename: P
authors.initials: P
authors.lastname: Ganz
authors.forename: D M
authors.initials: DM
authors.lastname: Briscoe
mesh_terms: D001706:Biopsy; D019013:CD40 Antigens / Q000235:genetics / Q000378:metabolism*; D023201:CD40 Ligand; D002478:Cells, Cultured; D004730:Endothelium, Vascular / Q000378:metabolism; D015870:Gene Expression; D006084:Graft Rejection / Q000276:immunology*; D016027:Heart Transplantation / Q000276:immunology*; D006801:Humans; D007124:Immunoenzyme Techniques; D008562:Membrane Glycoproteins / Q000235:genetics / Q000378:metabolism*; D008833:Microcirculation; D012333:RNA, Messenger / Q000235:genetics
chemical_list: D019013:CD40 Antigens; D008562:Membrane Glycoproteins; D012333:RNA, Messenger; D023201:CD40 Ligand