title: Rantes production during development of cardiac allograft vasculopathy.
abstract: BACKGROUND
  RANTES (regulated on activation, normal T cell expressed and secreted) production has been shown to correlate with mononuclear cell recruitment and precede intimal thickening in cardiac allograft vasculopathy (CAV). However, the cells that produce RANTES in CAV are undefined. Therefore, in an MHC II-mismatched murine model of CAV, we sought to (1) define the cellular sources of RANTES and (2) determine the role of CD4+ lymphocytes in RANTES production during CAV development.
  
  
  METHODS
  B6.CH-2bm12 strain donor hearts were transplanted heterotopically into wild-type (WT) or CD4 knockout (CD4KO) C57BL/6 mice (MHC II mismatch). No immunosuppression was used. Recipients were sacrificed at 7, 14, and 24 days. Intragraft RANTES gene expression and protein levels were determined with ribonuclease protection assay and ELISA, respectively. At days 7 and 24, RANTES production by graft-infiltrating cells was defined with intracellular RANTES staining and multicolor FACS analysis. Intimal thickening was quantitated morphometrically. In murine hearts and in six explanted human hearts with advanced CAV, RANTES was also localized immunohistochemically.
  
  
  RESULTS
  NK, NKT, and gammadelta+ cells, in addition to CD4+, CD8+ lymphocytes, and CD11b+ macrophages, produced RANTES in early and late stages of CAV. RANTES-producing NK, NKT, and gammadelta+ cells tripled in number during CAV development; by day 24, NK and gammadelta+ cells each outnumbered CD4+ lymphocytes and CD11b+ macrophages. The presence of CD4+ lymphocytes was required for sustained RANTES production in allografts, which correlated with mononuclear cell recruitment and preceded intimal thickening. In murine and explanted human hearts with advanced CAV, RANTES immunolocalized with graft-infiltrating mononuclear cells and vessel wall cells.
  
  
  CONCLUSIONS
  We present evidence that other cell types in addition to CD4+, CD8+ T lymphocytes, and CD11b+ macrophages contribute significantly to RANTES production in CAV. In this MHC II-mismatched murine model of CAV, sustained RANTES production requires CD4+ lymphocytes, correlates with mononuclear cell recruitment, and precedes intimal thickening. In experimental and human CAV, vessel wall cells may also produce RANTES. Interventions aimed at inhibiting RANTES production in CAV may need to target several types of cells, and neutralization of RANTES bioactivity may reduce mononuclear cell recruitment and CAV development.
authors: Division of Cardiothoracic Surgery, Department of Surgery, UCLA School of Medicine, University of California at Los Angeles, USA.
authors: J J
authors: JJ
authors: Yun
authors: M P
authors: MP
authors: Fischbein
authors: H
authors: H
authors: Laks
authors: Y
authors: Y
authors: Irie
authors: M L
authors: ML
authors: Espejo
authors: M C
authors: MC
authors: Fishbein
authors: J A
authors: JA
authors: Berliner
authors: A
authors: A
authors: Ardehali
mesh_terms: D000818:Animals; D015704:CD4 Antigens / Q000235:genetics; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism; D018946:Chemokine CCL5 / Q000096:biosynthesis* / Q000235:genetics; D003327:Coronary Disease / Q000209:etiology* / Q000235:genetics / Q000378:metabolism*; D015870:Gene Expression; D016027:Heart Transplantation / Q000009:adverse effects*; D007150:Immunohistochemistry; D051379:Mice; D008810:Mice, Inbred C57BL; D018345:Mice, Knockout / Q000235:genetics; D009000:Monocytes / Q000502:physiology; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D014018:Tissue Distribution; D014184:Transplantation, Homologous / Q000009:adverse effects
chemical_list: D015704:CD4 Antigens; D018946:Chemokine CCL5