title: Indirect recognition of donor HLA class I peptides in lung transplant recipients with bronchiolitis obliterans syndrome.
abstract: BACKGROUND
  The presentation of donor MHC class II-derived peptides by host antigen-presenting cells in the context of self-MHC class II molecules has been suggested as a mechanism for the chronic rejection of kidney and heart allografts. The aim of this study was to determine whether indirect allorecognition of HLA class I-derived peptides occurred in lung transplant (LTx) recipients and whether it correlated with the development of bronchiolitis obliterans syndrome (BOS).
  
  
  METHODS
  Peripheral blood mononuclear cells from LTx recipients were cultured with synthetic peptides corresponding to the hypervariable regions of the mismatched HLA class I antigens of the donor. Proliferation and precursor frequency (PF) of allopeptide reactive T cells were determined by the incorporation of [3H]thymidine into DNA and limiting dilution analysis.
  
  
  RESULTS
  Peripheral blood leukocytes of LTx recipients with BOS mismatched for HLA class I molecules showed a proliferative response three- to fourfold higher than those observed in mismatched recipients without BOS and in normal control individuals (P<0.001). Similarly, the PF of allopeptide-reactive T cell was 3- to 24-fold higher in recipients with BOS compared with recipients without BOS (P<0.05) as well as normal control individuals (P<0.03). The T cell PF to donor-specific allopeptides, as well as irrelevant allopeptides, was not significantly different in LTx recipients without BOS and normal control individuals.
  
  
  CONCLUSIONS
  These data suggest that T cells from LTx recipients are sensitized to mismatched HLA class I antigens. The sensitization was significantly higher in LTx recipients with BOS compared with LTx recipients without BOS. Strategies to block T-cell responses generated by indirect allorecognition after lung transplantation may provide a means for the prevention or treatment of BOS in LTx recipients.
authors.affiliation: Department of Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
authors.forename: K S
authors.initials: KS
authors.lastname: SivaSai
authors.forename: M A
authors.initials: MA
authors.lastname: Smith
authors.forename: N J
authors.initials: NJ
authors.lastname: Poindexter
authors.forename: S R
authors.initials: SR
authors.lastname: Sundaresan
authors.forename: E P
authors.initials: EP
authors.lastname: Trulock
authors.forename: J P
authors.initials: JP
authors.lastname: Lynch
authors.forename: J D
authors.initials: JD
authors.lastname: Cooper
authors.forename: G A
authors.initials: GA
authors.lastname: Patterson
authors.forename: T
authors.initials: T
authors.lastname: Mohanakumar
mesh_terms: D001989:Bronchiolitis Obliterans / Q000276:immunology*; D002455:Cell Division / Q000502:physiology; D015395:Histocompatibility Antigens Class I / Q000276:immunology*; D006801:Humans; D008168:Lung / Q000276:immunology*; D016040:Lung Transplantation / Q000276:immunology*; D011183:Postoperative Complications / Q000276:immunology; D013234:Stem Cells / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology; D014019:Tissue Donors
chemical_list: D015395:Histocompatibility Antigens Class I