title: Attenuation of transplant arteriosclerosis with clopidogrel is associated with a reduction of infiltrating dendritic cells and macrophages in murine aortic allografts.
abstract: BACKGROUND
  Monotherapy with clopidogrel reduced the formation of transplant arteriosclerosis in a murine aortic allograft model. However, the underlying immunologic mechanisms are still unknown.
  
  
  METHODS
  Fully major histocompatibility complex-mismatched C57BL/6 (H2b) donor aortas were transplanted into CBA.J (H2k) recipients and mice received different doses (1, 10, and 20 mg/kg) of clopidogrel, an antagonist of the P2Y12 ADP receptor on platelets, or control saline for 30 days. Blood was analyzed for changes in adhesion molecule and sCD40L concentrations by ELISA. Grafts were analyzed by histology, morphometry, and immunofluorescence on day 30 after transplantation. Intragraft cytokine mRNA production was analyzed by reverse-transcriptase polymerase chain reaction on day 14 after transplantation.
  
  
  RESULTS
  Treatment with clopidogrel resulted in significantly decreased blood concentrations of sCD40L and P-selectin after transplantation. Cellular analysis of the aortic transplant revealed fewer numbers of infiltrating dendritic cells (CD205+) and macrophages (F4/80+) after application of clopidogrel, whereas T-cells within the graft were unaltered. In addition cellular P-/E-selectin, ICAM-1, and platelet-derived-growth-factor (PDGF)-beta surface expression were significantly reduced as compared with untreated controls. Intragraft mRNA expression confirmed these results and showed significant lower production of P-/E-selectin, ICAM-1, and PDGF-beta after treatment with clopidogrel. Antiglycoprotein-Ib and antiglycoprotein VI had no beneficial effect on the development of transplant arteriosclerosis.
  
  
  CONCLUSIONS
  This report shows that application of clopidogrel after transplantation results in a reduction in adhesion molecule expression within the blood and transplant tissue and is associated with reduced transendothelial migration of dendritic cells and macrophages within the vascular wall.
authors.affiliation: Department of Cardiac Surgery, Friedrich-Alexander University Erlangen-Nürnberg, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Abele
authors.forename: Bernd M
authors.initials: BM
authors.lastname: Spriewald
authors.forename: Martina
authors.initials: M
authors.lastname: Ramsperger-Gleixner
authors.forename: Martina
authors.initials: M
authors.lastname: Wollin
authors.forename: Nicola E
authors.initials: NE
authors.lastname: Hiemann
authors.forename: Bernhard
authors.initials: B
authors.lastname: Nieswandt
authors.forename: Michael
authors.initials: M
authors.lastname: Weyand
authors.forename: Stephan M
authors.initials: SM
authors.lastname: Ensminger
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal; D015703:Antigens, CD / Q000378:metabolism; D000943:Antigens, Differentiation / Q000378:metabolism; D001012:Aorta, Abdominal / Q000187:drug effects* / Q000276:immunology / Q000473:pathology / Q000637:transplantation; D001161:Arteriosclerosis / Q000276:immunology / Q000473:pathology / Q000517:prevention & control*; D023201:CD40 Ligand / Q000097:blood; D015815:Cell Adhesion Molecules / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D002633:Chemotaxis / Q000187:drug effects*; D000077144:Clopidogrel; D003713:Dendritic Cells / Q000187:drug effects* / Q000276:immunology; D004305:Dose-Response Relationship, Drug; D015536:Down-Regulation; D006650:Histocompatibility Testing; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D037181:Lectins, C-Type / Q000378:metabolism; D008264:Macrophages / Q000187:drug effects* / Q000276:immunology; D051379:Mice; D008810:Mice, Inbred C57BL; D008808:Mice, Inbred CBA; D015778:Minor Histocompatibility Antigens; D019007:P-Selectin / Q000097:blood; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D019038:Platelet Glycoprotein GPIb-IX Complex / Q000276:immunology; D010980:Platelet Membrane Glycoproteins / Q000276:immunology; D010982:Platelet-Derived Growth Factor / Q000378:metabolism; D012333:RNA, Messenger / Q000378:metabolism; D011956:Receptors, Cell Surface / Q000378:metabolism; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000494:pharmacology; D014184:Transplantation, Homologous
chemical_list: D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D000943:Antigens, Differentiation; D015815:Cell Adhesion Molecules; C093569:DEC-205 receptor; D015850:Interleukin-6; D037181:Lectins, C-Type; D015778:Minor Histocompatibility Antigens; D019007:P-Selectin; D010975:Platelet Aggregation Inhibitors; D019038:Platelet Glycoprotein GPIb-IX Complex; D010980:Platelet Membrane Glycoproteins; D010982:Platelet-Derived Growth Factor; D012333:RNA, Messenger; D011956:Receptors, Cell Surface; C036763:monocyte-macrophage differentiation antigen; C098341:platelet membrane glycoprotein VI; D018799:Intercellular Adhesion Molecule-1; D023201:CD40 Ligand; D000077144:Clopidogrel; D013988:Ticlopidine