title: CD8+ lymphocytes augment chronic rejection in a MHC class II mismatched model.
abstract: Chronic rejection, or cardiac allograft vasculopathy (CAV), remains the leading cause of late death in heart transplant recipients. The precise role and contributions of T lymphocyte subsets to CAV development remains unknown.
  
  
  METHODS
  Donor hearts from B6.C-H2bm12 mice were transplanted into T lymphocyte subset knockout recipients and T lymphocyte-reconstituted nude recipients. No immunosuppression was used. Intimal proliferation was measured morphometrically. In vitro studies were performed to analyze the donor-specific activation status of recipient CD8+ lymphocytes by examining cellular proliferation, interleukin-2 secretion, and interleukin-2Ralpha expression. Intracellular cytokine staining assay was performed to determine both the profile and source of intragraft cytokines.
  
  
  RESULTS
  Hearts transplanted into wild-type recipients developed severe CAV by 24 days. Intimal lesions were absent in the hearts that were transplanted into nude and CD4-/- knockout mice (containing CD8+ lymphocytes). In contrast, the donor hearts in CD8-/- knockout recipients (containing CD4+ lymphocytes) developed CAV, but significantly less than in wildtype. Adoptive transfer of T lymphocyte subset populations into nude recipients confirmed that CAV was absolutely contingent on CD4+ lymphocytes, and that CD8+ lymphocytes played an additive role in intimal lesion progression in the presence of CD4+ lymphocytes. Although CD8+ lymphocytes alone did not cause CAV in vivo, we demonstrated that MHC class II disparate alloantigens activated CD8+ lymphocytes both in vivo and in vitro. Finally, both CD4+ and CD8+ lymphocytes contributed to the intragraft IL-2 and IFN-gamma production.
  
  
  CONCLUSIONS
  In this MHC class II mismatched murine model, CAV is a T lymphocyte dependent event, and absolutely contingent on the presence of CD4+ lymphocytes. Furthermore, CD8+ lymphocytes (1) are activated by MHC class II disparate antigens and (2) play a significant role in the progression of lesion development. Finally, both CD4+ and CD8+ lymphocytes contribute to CAV development via secretion of IFN-gamma, a known mediator of CAV in this model.
authors.affiliation: Department of Surgery, UCLA School of Medicine, University of California at Los Angeles, 90095, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Fischbein
authors.forename: J
authors.initials: J
authors.lastname: Yun
authors.forename: H
authors.initials: H
authors.lastname: Laks
authors.forename: Y
authors.initials: Y
authors.lastname: Irie
authors.forename: M C
authors.initials: MC
authors.lastname: Fishbein
authors.forename: M
authors.initials: M
authors.lastname: Espejo
authors.forename: B
authors.initials: B
authors.lastname: Bonavida
authors.forename: A
authors.initials: A
authors.lastname: Ardehali
mesh_terms: D000818:Animals; D015704:CD4 Antigens / Q000235:genetics / Q000502:physiology*; D016516:CD4-CD8 Ratio; D016827:CD8 Antigens / Q000235:genetics / Q000502:physiology*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D016027:Heart Transplantation / Q000276:immunology*; D000949:Histocompatibility Antigens Class II / Q000276:immunology*; D006650:Histocompatibility Testing; D051379:Mice; D008810:Mice, Inbred C57BL; D008815:Mice, Inbred Strains; D018345:Mice, Knockout; D008819:Mice, Nude; D016176:T-Lymphocyte Subsets / Q000276:immunology
chemical_list: D015704:CD4 Antigens; D016827:CD8 Antigens; D000949:Histocompatibility Antigens Class II