title: Intragraft proliferating T lymphocytes are associated with moderate acute pulmonary rejection.
abstract: Acute allograft rejection is characterized by infiltration of the donor organ by host lymphoid cells, predominantly T lymphocytes. However, the site of proliferation and clonal expansion of alloreactive T lymphocytes is not well defined in man. A group of normal transbronchial biopsies (TBB, n=9) from clinically well lung transplant recipients was compared to TBB showing acute rejection (at least grade A2, n=9), using CD3- and Ki67-specific antibodies to double-label proliferating T lymphocytes. Few double-labeled lymphocytes were present in the normal biopsies (range, 0-3 cells). However, five of the rejection biopsies contained significant numbers of proliferating T lymphocytes (range, 19-47; Fisher's exact test; P=0.029). Furthermore, this positive group contained all three cases of grade A3 rejection in the study, as well as a case with persistent grade A2 rejection on follow-up biopsy. These data demonstrate that T lymphocytes do proliferate in transplanted human lungs; such proliferation is associated with more severe rejection.
authors.affiliation: Department of Pathology, University of Newcastle, Newcastle-upon-Tyne, United Kingdom.
authors.forename: D S
authors.initials: DS
authors.lastname: Milne
authors.forename: J V
authors.initials: JV
authors.lastname: Moy
authors.forename: P A
authors.initials: PA
authors.lastname: Corris
authors.forename: H
authors.initials: H
authors.lastname: Robertson
authors.forename: A
authors.initials: A
authors.lastname: De Soyza
authors.forename: J A
authors.initials: JA
authors.lastname: Kirby
authors.forename: A C
authors.initials: AC
authors.lastname: Cunningham
mesh_terms: D000208:Acute Disease; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D016040:Lung Transplantation / Q000276:immunology*; D008213:Lymphocyte Activation; D013601:T-Lymphocytes / Q000276:immunology*