title: Positive association of anticytoskeletal endothelial cell antibodies and cardiac allograft rejection.
abstract: Using an indirect immunofluorescence method on human umbilical vein endothelial cells (HUVEC), we investigated the presence of antiendothelial cell antibodies (AECA) in 136 pre- and posttransplant serum samples sequentially collected from 31 patients during the first year after cardiac transplantation. A healthy control group was also included (n = 87). Colocalization studies demonstrated a positive staining pattern of different cytoskeletal components (cytoskeletal-antiendothelial cell antibodies, CSK-AECA) including antivimentin, antiactin, antitubulin, and anticytokeratin among heart transplanted patients. Frequency of CSK-AECA in the control group and at day 0 in the transplant group was 18.3 and 22.5%, respectively (p = NS). A progressive increase in the frequency of CSK-AECA was observed after cardiac transplantation: 13.3% at day 15; 22.2% at day 30; 53.8% at day 90, and 58% at day 360. Interestingly, rejection episodes within the first year after transplantation occurred in 83.3% of CSK-AECA-positive and in 30.7% of CSK-AECA-negative patients (p = 0.0045). The presence of antibodies was detected prior to the rejection event and was associated with a poor clinical outcome: rejection episodes occurred at a mean of 36.14 +/- 17 days after transplantation in patients with preexisting AECA and 174.25 +/- 51.9 days after de novo antibody appearance in patients with no antibodies at day 0 (p = 0.029). In conclusion, a progressive increase in the frequency of CSK-AECA was observed following cardiac transplantation; the presence of these antibodies is strongly associated and precedes the rejection episodes. Thus, CSK-AECA could be a good marker for acute graft rejection.
authors.affiliation: Servicio de Inmunología, Hospital Universitario Virgen del Rocío, Seville, Spain. tamexplorer@yahoo.es <tamexplorer@yahoo.es>
authors.forename: Antonia
authors.initials: A
authors.lastname: Alvarez-Márquez
authors.forename: Isabel
authors.initials: I
authors.lastname: Aguilera
authors.forename: Rosa María
authors.initials: RM
authors.lastname: Blanco
authors.forename: Domingo
authors.initials: D
authors.lastname: Pascual
authors.forename: Mercedes
authors.initials: M
authors.lastname: Encarnación-Carrizosa
authors.forename: Maria Rocío
authors.initials: MR
authors.lastname: Alvarez-López
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Wichmann
authors.forename: Antonio
authors.initials: A
authors.lastname: Núñez-Roldán
mesh_terms: D000199:Actins / Q000276:immunology; D000328:Adult; D000818:Animals; D000911:Antibodies, Monoclonal / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006084:Graft Rejection / Q000276:immunology*; D016027:Heart Transplantation / Q000276:immunology*; D006801:Humans; D007633:Keratins / Q000276:immunology; D008297:Male; D051379:Mice; D008875:Middle Aged; D014184:Transplantation, Homologous / Q000276:immunology; D014404:Tubulin / Q000276:immunology; D014746:Vimentin / Q000276:immunology
chemical_list: D000199:Actins; D000911:Antibodies, Monoclonal; D001323:Autoantibodies; D014404:Tubulin; D014746:Vimentin; C087589:anti-endothelial cell antibody; D007633:Keratins