[Immunologic, alloantigen-dependent factors in chronic graft rejection].
BACKGROUND
The pathogenesis of chronic renal allograft rejection is still speculative. Amongst other factors immune-mediated graft injury is proposed. Since the allo-antigen is specifically recognized by the variable (V) alpha and beta chains of the T-cell receptor, a restricted T-cell repertoire might support the notion of allo-antigen involvement in chronic rejection.


METHODS
By the means of semiquantitative polymerase chain reaction the V beta families 1-20 were assessed in allograft biopsies with histologically confirmed chronic and acute rejection. At the same time the V beta repertoire was analyzed in PBMC.


RESULTS
The intragraft V beta repertoire was limited to 1 to 3 dominant V beta families in chronic and acute rejection. The response was highly individual and did not correlate to the type or degree of HLA mismatches. The T-cell repertoire in PBMC was polyclonal and did not reflect the immune response in the graft.


CONCLUSIONS
The finding of a restricted V beta repertoire in both forms of rejection might indicate an immunological basis not only for acute, but also for ongoing chronic rejection. Tailor-made antibodies against the dominant V beta clones might provide a tool for selective immunosuppression in both entities of rejection targeting only those T cells which were activated by allo-antigens.
Barth
C
C
Klinik IV für Medizin, Universitätsklinik Köln.
Stachowski
J
J
von Menges
A
A
Lammerding
P
P
Baldamus
C A
CA
D000818:Animals; D002908:Chronic Disease; D006084:Graft Rejection / Q000276:immunology*; D006801:Humans; D007519:Isoantigens / Q000276:immunology*; D016693:Receptors, Antigen, T-Cell, alpha-beta / Q000276:immunology; D014181:Transplantation Immunology / Q000276:immunology*
D007519:Isoantigens; D016693:Receptors, Antigen, T-Cell, alpha-beta
Immunologische, alloantigenabhängige Faktoren in der chronischen Transplantatabstossung.