title: Histopathologic characterization of mild rejection (grade I) in skin biopsies of human hand allografts.
abstract: Mild skin rejection is a common observation in reconstructive transplantation. To enlighten the role of this inflammatory reaction we investigated markers for cellular and antibody mediated rejection, adhesion molecules and tolerance markers. Forty-seven skin biopsies (rejection grade I) of human hand allografts were investigated by immunohistochemistry (CD3, CD4, CD8, CD20, CD68, C4d, LFA-1, ICAM-1, E-selectin, P-selectin, VE-cadherin, HLA-DR, IDO, and Foxp3). Expression was read with respect to time after transplant. The infiltrate was mainly comprised of CD3+T-lymphocytes. Among these, CD8+cells were more prominent than CD4+cells. CD20+B-lymphocytes were sparse and CD68+macrophages were found in some, but not all samples (approximately 10% of the infiltrate). The CD4/CD8-ratio was increased after the first year. C4d staining was mainly positive in samples at time-points later than 1 year. Adhesion molecules LFA-1, ICAM-1, E-selectin, P-selectin, and VE-cadherin were found upregulated, and for P-selectin, expression increased with time after transplant. IDO expression was strongest at 3 months-1 year post-transplant and a tendency toward more Foxp3+ cells at later time points was observed. Mild skin rejection after hand transplantation presents with a T-cell dominated dermal cell infiltrate and upregulation of adhesion molecules. The role of C4d expression after year one remains to be elucidated.
authors: Center of Operative Medicine, Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Innsbruck, Austria.
authors: Theresa
authors: T
authors: Hautz
authors: Bettina
authors: B
authors: Zelger
authors: Gerald
authors: G
authors: Brandacher
authors: Hansgeorg
authors: H
authors: Mueller
authors: Johanna
authors: J
authors: Grahammer
authors: Bernhard
authors: B
authors: Zelger
authors: Andrew  W P
authors: A
authors: Lee
authors: Pedro
authors: P
authors: Cavadas
authors: Raimund
authors: R
authors: Margreiter
authors: Johann
authors: J
authors: Pratschke
authors: Stefan
authors: S
authors: Schneeberger
mesh_terms: D001706:Biopsy / Q000379:methods*; D015815:Cell Adhesion Molecules / Q000378:metabolism; D005260:Female; D020869:Gene Expression Profiling; D006084:Graft Rejection; D063987:Hand Transplantation; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007249:Inflammation; D008297:Male; D010641:Phenotype; D012867:Skin / Q000276:immunology / Q000473:pathology; D013601:T-Lymphocytes / Q000378:metabolism
chemical_list: D015815:Cell Adhesion Molecules