title: Analysis of immune markers in human cardiac allograft recipients and association with coronary artery vasculopathy.
abstract: BACKGROUND
  Because coronary artery vasculopathy (CAV) is a common cause of late cardiac allograft loss in humans, there is a need to develop and test non-invasive surrogate markers capable of detecting and predicting this disease entity.
  
  
  METHODS
  We performed a cross-sectional analysis of immune-based surrogate markers in 65 primary cardiac allograft recipients with or without angiographically documented CAV. Anti-donor cellular immunity was determined by interferon gamma (IFN)-gamma enzyme-linked immunosorbent spot (ELISPOT) assays using donor HLA-derived peptides (indirect pathway), and anti-donor alloantibodies were detected by flow cytometry using HLA-coated beads.
  
  
  RESULTS
  Anti-donor cellular and humoral immunity were detected more frequently in patients with CAV (17 of 32, 53.1%) than in controls (4 of 33, 12.1%) (p < 0.001). Anti-donor cellular and humoral immunity were detected in different sub-groups of CAV patients; peripheral blood lymphocytes (PBLs) from only 1 of 32 CAV patients reacted to donor peptides with simultaneous detection of peripheral anti-donor alloantibodies.
  
  
  CONCLUSIONS
  Immune reactivity in cardiac transplant recipients with CAV differs significantly from those without CAV and the detected responses are heterogeneous in nature. Serial assessments of anti-donor immunity using different methods will be required to detect and possibly predict outcome in cardiac transplant recipients.
authors.affiliation: Department of Immunology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Emilio D
authors.initials: ED
authors.lastname: Poggio
authors.forename: Meagan
authors.initials: M
authors.lastname: Roddy
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Riley
authors.forename: Michael
authors.initials: M
authors.lastname: Clemente
authors.forename: Donald E
authors.initials: DE
authors.lastname: Hricik
authors.forename: Randall
authors.initials: R
authors.lastname: Starling
authors.forename: James B
authors.initials: JB
authors.lastname: Young
authors.forename: Barbara
authors.initials: B
authors.lastname: Gus
authors.forename: Mohamad H
authors.initials: MH
authors.lastname: Yamani
authors.forename: Peter S
authors.initials: PS
authors.lastname: Heeger
mesh_terms: D000917:Antibody Formation / Q000276:immunology; D015415:Biomarkers / Q000032:analysis*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000276:immunology*; D003430:Cross-Sectional Studies; D005260:Female; D006680:HLA Antigens / Q000032:analysis*; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D007371:Interferon-gamma / Q000032:analysis*; D007518:Isoantibodies / Q000032:analysis; D008297:Male; D008875:Middle Aged; D014180:Transplantation
chemical_list: D015415:Biomarkers; D006680:HLA Antigens; D007518:Isoantibodies; D007371:Interferon-gamma