Intragraft interleukin 2 mRNA expression during acute cellular rejection and left ventricular total wall thickness after heart transplantation.
OBJECTIVE
To assess whether diastolic graft function is influenced by intragraft interleukin 2 (IL-2) messenger RNA (mRNA) expression in rejecting cardiac allografts.


METHODS
16 recipients of cardiac allografts were monitored during the first three months after transplantation. The presence of IL-2 mRNA in endomyocardial biopsies (n = 123) was measured by reverse transcriptase polymerase chain reaction. To determine heart function, concurrent M mode and two dimensional Doppler echocardiograms were analysed.


RESULTS
Histological signs of acute rejection (International Society for Heart and Lung Transplantation (ISHLT) rejection grade > 2) were strongly associated with IL-2 mRNA expression (IL-2 mRNA was present in 12 of 20 endomyocardial biopsies (60%) with acute rejection and in 24 of 103 endomyocardial biopsies (23%) without acute rejection, p = 0.002). No significant relation was found between either histology or IL-2 mRNA expression alone and the studied echocardiographic parameters. However, stratification of the echocardiographic data into those of patients with and those without acute rejection showed that during acute rejection IL-2 mRNA expression was significantly associated with increased left ventricular total wall thickness (mean change in total wall thickness was +0.22 cm in patients with IL-2 mRNA expression versus -0.18 cm in patients without IL-2 mRNA expression, p = 0.048).


CONCLUSIONS
An increase in left ventricular total wall thickness precedes IL-2 positive acute rejection after heart transplantation. Thus, cardiac allograft rejection accompanied by intragraft IL-2 mRNA expression may be indicative of more severe rejection episodes.
de Groot-Kruseman
H A
HA
Department of Internal Medicine, University Hospital Rotterdam, Rotterdam, Netherlands. hadegroot@inw1.azr.nl
Baan
C C
CC
Hagman
E M
EM
Mol
W M
WM
Niesters
H G
HG
Maat
A P
AP
Zondervan
P E
PE
Weimar
W
W
Balk
A H
AH
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001706:Biopsy / Q000379:methods; D015150:Echocardiography, Doppler; D005260:Female; D006084:Graft Rejection / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D016027:Heart Transplantation / Q000276:immunology* / Q000473:pathology; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D007376:Interleukin-2 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology* / Q000378:metabolism / Q000473:pathology; D012333:RNA, Messenger / Q000378:metabolism; D014184:Transplantation, Homologous; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000473:pathology
D007376:Interleukin-2; D012333:RNA, Messenger